Shy-drager syndrome: Diagnosis and treatment of cholinergic dysfunction

Ramesh K. Khurana, Erland Nelson, Biagio Azzarelli, Julio H. Garcia

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Two patients with Shy-Drager syndrome demonstrated unusually widespread and unequivocal cholinergic dysfunction as well as the usual evidence of adrenergic insufficiency. Progressive constipation preceded impotence, nocturia, hesitancy in micturition, anhidrosis, orthostatic hypotension, and xerostomia. Nonautonomic neurologic signs appeared several years later. Cholinergic dysfunction involved eyes, lacrimal glands, salivary glands, heart, gastrointestinal tract, urinary bladder, and sweat glands. Subcutaneous administration of bethanechol chloride—a muscarinic receptor agonist—improved tearing, salivation, sweating, and gastrointestinal and bladder functions. Daily administration of this drug resulted in symptomatic improvement of the autonomic functions, and relapse followed discontinuation of treatment.

Original languageEnglish (US)
Pages (from-to)805-809
Number of pages5
Issue number8
StatePublished - Aug 1980
Externally publishedYes

ASJC Scopus subject areas

  • Clinical Neurology


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