Download PDF
Semin Respir Crit Care Med 2002; 23(3): 261-266
DOI: 10.1055/s-2002-33034
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Respiratory Complications of Parkinson's Disease

Holly Shill1 , Mark Stacy2
  • 1Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
  • 2Muhammad Ali Parkinson Research Center, Barrow Neurological Institute, Phoenix, Arizona
Further Information

Publication History

Publication Date:
02 August 2002 (online)

    Permissions and Reprints

ABSTRACT

Patients with Parkinson's disease are at risk for pulmonary complications as a consequence of both the underlying disease pathology and the side effects of medication. Degeneration of the substantia nigra and subsequent loss of dopaminergic neurons may produce changes in ventilatory parameters. Upper airway obstruction and chest wall restriction are both common, and both may respond to levodopa. However, therapy for Parkinson's may also contribute to pulmonary morbidity. Overtreatment with levodopa causes respiratory dyskinesia that may be difficult to differentiate from complications of the disease itself. Therapy with ergot derivatives may cause pleuropulmonary fibrosis. Pneumonia resulting from the respiratory complications remains a significant cause of morbidity and mortality in Parkinson's disease.

KEYWORDS

Parkinson's disease - dopaminergic - levodopa - chest wall rigidity - pulmonary complications

REFERENCES

  • 1 Parkinson J. An essay on the shaking palsy.  London: Sherwood, Nealy and Jones; 1817
    Google Scholar
  • 2 Hoehn M M, Yahr M D. Parkinsonism: onset, progression and mortality.  Neurology . 1967;  17 427-442
    CrossrefPubMedGoogle Scholar
  • 3 Schwab R D, England A C, Peterson E. Akinesia in Parkinson's disease.  Neurology . 1959;  9 65-72
    PubMedGoogle Scholar
  • 4 Baker K K, Ramig L O, Luschei E S, Smith M E. Thyroarytenoid muscle activity associated with hypophonia in Parkinson disease and aging.  Neurology . 1998;  51 1592-1598
    CrossrefPubMedGoogle Scholar
  • 5 Jankovic J, Cardoso F, Grossman R G, Hamilton W J. Outcome after stereotactic thalamotomy for parkinsonian, essential, and other types of tremor.  Neurosurgery . 1995;  37 680-687
    PubMedGoogle Scholar
  • 6 Lang A E, Duff J, Saint-Cyr J A. Posteroventral medial pallidotomy in Parkinson's disease.  J Neurol . 1999;  S28-S41
    PubMedGoogle Scholar
  • 7 Berke G S, Gerratt B, Kreiman J, Jackson K. Treatment of Parkinson hypophonia with percutaneous collagen augmentation.  Laryngoscope . 1999;  109 1295-1299
    PubMedGoogle Scholar
  • 8 Hovestadt A, Bogaard J M, Meerwaldt J D. Pulmonary function in Parkinson's disease.  J Neurol Neurosurg Psychiatry . 1989;  52 329-333
    CrossrefPubMedGoogle Scholar
  • 9 Fontana G A, Pantaleo T, Lavorini F. Defective motor control of coughing in Parkinson's disease.  Am J Respir Crit Care Med . 1998;  158 458-464
    CrossrefPubMedGoogle Scholar
  • 10 Vincken W G, Gauthier S G, Dollfuss R E. Involvement of upper-airway muscles in extrapyramidal disorders: a cause of airflow limitation.  N Engl J Med . 1984;  311 438-442
    CrossrefPubMedGoogle Scholar
  • 11 Neu H C, Connolly Jr J J, Schwertley F W. Obstructive respiratory dysfunction in parkinsonian patients.  Am Rev Respir Dis . 1967;  95 33-47
    PubMedGoogle Scholar
  • 12 Izquierdo-Alonso J L, Jimenez-Jimenez F J, Cabrera-Valdivia F, Mansilla-Lesmes M. Airway dysfunction in patients with Parkinson's disease.  Lung . 1994;  172 47-55
    PubMedGoogle Scholar
  • 13 Kinnier-Wilson S A. Neurology.  Baltimore, Md: Willams & Wilkins; 1940
    Google Scholar
  • 14 Sabate M, Gonzalez I, Ruperez F, Rodriguez M. Obstructive and restrictive pulmonary dysfunctions in Parkinson's disease.  J Neurol Sci . 1996;  138 114-119
    CrossrefPubMedGoogle Scholar
  • 15 de Bruin F P, de Bruin M V, Lees A J, Pride N B. Effects of treatment on airway dynamics and respiratory muscle strength in Parkinson's disease.  Am Rev Respir Dis . 1993;  148 1576-1580
    CrossrefPubMedGoogle Scholar
  • 16 Herer B, Arnulf I, Housset B. Effects of levodopa on pulmonary function in Parkinson's disease.  Chest . 2001;  119(2) 387-393
    CrossrefPubMedGoogle Scholar
  • 17 Read D, Young A. Stridor and parkinsonism.  Postgrad Med J . 1983;  59 520-521
    PubMedGoogle Scholar
  • 18 Fink M E, Klebanoff L M, Lennihan L, Fahn S. Acute respiratory failure during drug manipulation in patients with Parkinson's disease.  Neurology . 1989;  39 348
    PubMedGoogle Scholar
  • 19 Riley D E, Grossman G, Martin L. Acute respiratory failure from dopamine agonist withdrawal.  Neurology . 1992;  42 1843-1844
    PubMedGoogle Scholar
  • 20 Easdown L J, Tessler M J, Minuk J. Upper airway involvement in Parkinson's disease resulting in postoperative respiratory failure.  Can J Anaesth . 1995;  42 344-347
    CrossrefPubMedGoogle Scholar
  • 21 Galvez-Jimenez N, Lang A E. Perioperative problems in Parkinson's disease and their management: apomorphine with rectal domperidone.  Can J Neurol Sci . 1996;  23 198-203
    PubMedGoogle Scholar
  • 22 Nugent C A, Harris H W, Cohn J. Dyspnea as a symptom in Parkinson's syndrome.  Am Rev Tuberc . 1958;  78 682-691
    PubMedGoogle Scholar
  • 23 Paulson G D, Tafrate R H. Some ``minor'' aspects of parkinsonism, especially pulmonary function.  Neurology . 1970;  20 14-17
    PubMedGoogle Scholar
  • 24 Bateman D N, Cooper R G, Gibson G J. Levodopa dosage and ventilatory function in Parkinson's disease.  Br Med J (Clin Res Ed) . 1981;  283 190-191
    PubMedGoogle Scholar
  • 25 Estenne M, Hubert M, De Troyer A. Respiratory-muscle involvement in Parkinson's disease.  N Engl J Med . 1984;  311 1516-1517
    CrossrefPubMedGoogle Scholar
  • 26 Sabate M, Rodriguez M, Mendez E. Obstructive and restrictive pulmonary dysfunction increases disability in Parkinson's disease.  Arch Phys Med Rehabil . 1996;  77 29-34
    CrossrefPubMedGoogle Scholar
  • 27 Apps M C, Sheaff P C, Ingram D A. Respiration and sleep in Parkinson's disease.  J Neurol Neurosurg Psychiatry . 1985;  48 1240-1245
    PubMedGoogle Scholar
  • 28 Silber M H, Levine S. Stridor and death in multiple system atrophy.  Mov Disord . 2000;  15 699-704
    CrossrefPubMedGoogle Scholar
  • 29 Chester C S, Gottfried S B, Cameron D I, Strohl K P. Pathophysiological findings in a patient with Shy-Drager and alveolar hypoventilation syndromes.  Chest . 1988;  94 212-214
    PubMedGoogle Scholar
  • 30 Weiner W J, Goetz C G, Nausieda P A, Klawans H L. Respiratory dyskinesias: extrapyramidal dysfunction and dyspnea.  Ann Intern Med . 1978;  88 327-331
    PubMedGoogle Scholar
  • 31 Zupnick H M, Brown L K, Miller A, Moros D A. Respiratory dysfunction due to L-dopa therapy for parkinsonism: diagnosis using serial pulmonary function tests and respiratory inductive plethysmography.  Am J Med . 1990;  89 109-114
    CrossrefPubMedGoogle Scholar
  • 32 Hartman D E. Stridor during dystonia phases of Parkinson's disease.  J Neurol Neurosurg Psychiatry . 1988;  51 161
    PubMedGoogle Scholar
  • 33 Vazquez A, Jimenez-Jimenez F J, Garcia-Ruiz P, Garcia-Urra D. ``Panic attacks'' in Parkinson's disease: a long-term complication of levodopa therapy.  Acta Neurol Scand . 1993;  87 14-18
    PubMedGoogle Scholar
  • 34 Stacy M. Pharmacotherapy for advanced Parkinson's disease.  Pharmacotherapy . 2000;  20(suppl 1, pt 2) S8-S16
    CrossrefPubMedGoogle Scholar
  • 35 Bhatt M H, Keenan S P, Fleetham J A, Calne D B. Pleuropulmonary disease associated with dopamine agonist therapy.  Ann Neurol . 1991;  30 613-616
    CrossrefPubMedGoogle Scholar
  • 36 Geminiani G, Fetoni V, Genitrini S. Cabergoline in Parkinson's disease complicated by motor fluctuations.  Mov Disord . 1996;  11 495-500
    CrossrefPubMedGoogle Scholar
  • 37 McElvaney N G, Wilcox P G, Churg A, Fleetham J A. Pleuropulmonary disease during bromocriptine treatment of Parkinson's disease.  Arch Intern Med . 1988;  148 2231-2236
    CrossrefPubMedGoogle Scholar
  • 38 Todman D H, Oliver W A, Edwards R L. Pleuropulmonary fibrosis due to bromocriptine treatment for Parkinson's disease.  Clin Exp Neurol . 1990;  27 79-82
    PubMedGoogle Scholar
  • 39 LeWitt P A, Calne D B. Pleuropulmonary changes during long-term bromocriptine treatment for Parkinson's disease.  Lancet . 1981;  1 44-45
    PubMedGoogle Scholar
  • 40 Hillerdal G, Lee J, Blomkvist A. Pleural disease during treatment with bromocriptine in patients previously exposed to asbestos.  Eur Respir J . 1997;  10 2711-2715
    CrossrefPubMedGoogle Scholar
  • 41 Canning C G, Alison J A, Allen N E, Groeller H. Parkinson's disease: an investigation of exercise capacity, respiratory function, and gait.  Arch Phys Med Rehabil . 1997;  78 199-207
    CrossrefPubMedGoogle Scholar
  • 42 Koseoglu F, Inan L, Ozel S. The effects of a pulmonary rehabilitation program on pulmonary function tests and exercise tolerance in patients with Parkinson's disease.  Funct Neurol . 1997;  12 319-325
    PubMedGoogle Scholar
  • 43 Tzelepis G E, McCool F D, Friedman J H, Hoppin Jr G F. Respiratory muscle dysfunction in Parkinson's disease.  Am Rev Respir Dis . 1988;  138 266-271
    PubMedGoogle Scholar
      >