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Anal Sphincter Dysfunction in Parkinson's Disease
S. E. Mathers, MRCP;
P. A. Kempster, FRACP, MRCP;
P. J. Law, FRCS;
J. P. Frankel, MRCP;
C. I. Bartram, FRCP, FRAR;
A. J. Lees, MD, FRCP;
G. M. Stern, MD, FRCP;
M. Swash, MD, FRCP, FRCPath
Arch Neurol. 1989;46(10):1061-1064.
Abstract
• Striated anal sphincter function was studied electrophysiologically and radiologically in six patients with Parkinson's disease and chronic constipation. In five cases, there was paradoxic anal sphincter muscle contraction during simulated defecation straining resembling anismustype pelvic outlet obstruction. Radiologic studies showed functional improvement of the defecatory mechanism following the administration of the dopamine receptor agonist apomorphine in four patients. Dysfunction of the striated anal sphincter musculature may be a significant cause of constipation in some parkinsonian patients, occurring as part of the generalized extrapyramidal motor disorder.
Author Affiliations
From the Departments of Physiology (Drs Mathers and Swash) and Radiology (Drs Law and Bartram), St Mark's Hospital; and the Department of Neurology, Middlesex Hospital (Drs Kempster, Frankel, Lees, and Stern), London, England.
Footnotes
Accepted for publication February 24, 1989.
Reprint requests to Department of Neurology, London Hospital, Whitechapel, London El 1BB, England (Dr Swash).
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