Symptoms associated with the involuntary nerves usually occur first. Motor problems similar to those found with Parkinson’s disease may develop later. Symptoms include:
- Dizziness or fainting when standing or sitting up, or changing positions
- Dizziness may be worse in the morning or after meals
- Fatigue after physical exertion
- Muscle weakness
- Neck ache, which may radiate to the shoulders
- Constipation or diarrhea
- Erectile dysfunction in men
- Loss of sex drive
- Inability to control bowels or bladder ( incontinence )
- Urinary frequency and urgency that may be especially bothersome at night (occurs early in the disease)
- Gasping or noisy breathing
- Short stops in breathing during sleep ( sleep apnea )
- Impaired temperature control
- Reduced sweating
- Dry skin
- Vision problems
- Abnormal eye movements
- Slurred, faint speech
- Trouble swallowing
- Poor balance
- Unsteady walking
- Slow movements
- Loss of facial expression
- Dementia (occurs late in the disease)
Your doctor will ask about your symptoms and medical history, and perform a physical exam. This disease is often hard to diagnose. There is no specific test for Shy-Drager syndrome, but testing helps rule out other conditions.
Tests may include:
- Blood tests—to measure electrolytes and other blood chemistries.
- MRI scan —a test that uses magnetic waves to make pictures of the inside of the body.
- Electromyogram (EMG) —a test that measures and records the electrical activity of the muscles at rest and when contracted. It can check for skeletal muscle weakness.
- Tilt-table test—measures changes in blood pressure as your body position changes
- Sleep studies—to check for disorders such as sleep apnea.
- Barium swallow —a series of x-rays of the upper digestive tract taken after you swallow a barium substance, which will show up on x-ray. In people with Shy-Drager syndrome, this test is used to assess swallowing problems.