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Parkinson's orthostatic hypotension — DGM MCQ

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ModerateMovement disordersParkinson's orthostatic hypotensionDGM

A 79-year-old woman with Parkinson's disease has dizziness and falls when standing. She has no vertigo and symptoms improve when lying down. Blood pressure is 138/78 mmHg lying and 102/60 mmHg standing. Current medicines include co-careldopa and amlodipine. What is the most appropriate assessment?

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Correct answer: C — Assess orthostatic hypotension and review contributing medicines

Parkinson's disease and antihypertensives can contribute to orthostatic hypotension, shown by symptomatic postural blood pressure drop. BPPV, sedatives, colonoscopy and reassurance do not address the demonstrated physiology. Autonomic dysfunction is a common non-motor feature of Parkinson's disease.

Reference: NICE NG71; NICE NG249