A runny nose, also known as rhinorrhea, is a common symptom that can have many different causes. Parkinson’s disease is a progressive nervous system disorder that affects movement and often causes tremors, stiffness, and balance issues. While a runny nose is not considered a primary symptom of Parkinson’s, some people with Parkinson’s do experience nasal and respiratory issues. In this article, we’ll look at the connection between Parkinson’s and runny nose symptoms and discuss the possible reasons a person with Parkinson’s might develop rhinorrhea.
Is a runny nose a direct symptom of Parkinson’s disease?
A runny nose itself is not a direct, primary symptom of Parkinson’s disease. The hallmark symptoms of Parkinson’s include:
- Tremors, usually starting in the hands
- Muscle stiffness and rigidity
- Slowed movement (bradykinesia)
- Impaired balance and coordination
These motor symptoms are caused by the loss of dopamine-producing neurons in a part of the brain called the substantia nigra. The substantia nigra is part of the basal ganglia, an area of the brain involved in coordination and control of movement. As Parkinson’s progresses, the loss of dopamine causes worsening symptoms.
On the other hand, a runny nose is most often caused by swelling and excess mucus production in the nasal passages and sinuses. This can be caused by allergies, infections, irritants, changes in weather or temperature, hormonal changes, and some medical conditions.
So in summary, a runny nose is not directly due to the dopamine deficiency or neurodegeneration of Parkinson’s itself. However, there are some indirect ways that Parkinson’s may increase nasal and respiratory symptoms.
Indirect links between Parkinson’s and runny nose
While not a primary symptom, a runny nose can develop indirectly due to Parkinson’s disease or its treatment in some cases. Possible reasons include:
Medications
Some Parkinson’s medications, especially older dopamine agonists like bromocriptine, are associated with runny nose side effects. Dopamine agonists mimic dopamine in the brain to improve motor symptoms. But when taken orally, they can also bind receptors in the nasal passages and stimulate mucus production.
More modern dopamine agonists like pramipexole and ropinirole are designed to target dopamine receptors in the brain more specifically, so they are less likely to cause rhinorrhea. But nasal congestion and drip are still possible side effects of some Parkinson’s drugs for certain people.
Dribbling and drooling
Saliva control and swallowing difficulties are common issues in Parkinson’s. Some people with Parkinson’s experience increased drooling or dribbling of saliva out of the mouth. This is related to facial and oral muscle rigidity and difficulty coordinating the muscles involved in swallowing.
The excess saliva dripping out of the mouth can cause irritation to the nasal passages and sinuses, leading to post-nasal drip and runny nose symptoms. Treating the drooling and swallowing problems may help reduce nasal irritation.
Poor nasal hygiene
Parkinson’s can make it difficult to carry out daily grooming activities due to tremor, rigidity, and reduced dexterity. People with Parkinson’s may have more difficulty thoroughly blowing their nose or using nasal irrigation devices. Leftover mucus and particles in the nasal passages can lead to dripping, irritation, and sinus infections.
Practicing good nasal hygiene like gentle nose blowing, saline rinses, and use of humidifiers may help reduce excess nasal mucus. Occupational therapists can provide tips and tools to make these tasks easier with Parkinson’s.
Less movement of cilia
The nasal passages and sinuses are lined with tiny, hair-like projections called cilia. The cilia normally move constantly in wave-like motions to sweep mucus and debris out of the nasal cavities.
In Parkinson’s disease, the cilia lining the nasal mucosa may become more rigid and move less efficiently. This can prevent normal clearing of mucus, leading to buildup, dripping, and congestion. Treatments like saline rinses may help compensate for less cilia motion.
Autonomic dysfunction
Many people with Parkinson’s experience autonomic nervous system dysfunction. This controls involuntary functions like heart rate, digestion, respiratory rate, and mucus secretion. When the autonomic nerves malfunction, it can cause increased nasal congestion and runniness. Managing autonomic dysfunction through diet, exercise, and medication may improve these symptoms.
Airway inflammation
One study found that people with Parkinson’s disease have higher levels of inflammation in their nasal and respiratory airway tissues compared to healthy controls. This inflammation can increase mucus secretion and stuffiness. The reason for the airway inflammation is not fully understood yet. Controlling allergy, sinusitis, and environmental triggers may help reduce it.
Treating a runny nose in Parkinson’s
If nasal and respiratory symptoms are bothersome for a Parkinson’s patient, there are a few treatment approaches that may help:
- Adjusting Parkinson’s medications – lowering the dose or switching medications can sometimes reduce rhinorrhea caused by drug side effects.
- Treating medical causes – identifying and treating any nasal allergies, sinus infections, or other medical causes behind the symptoms.
- Nasal hygiene – practicing good nasal blowing, humidifying the air, using saline nasal sprays or irrigation can help clear excess mucus.
- Medications – nasal decongestant sprays can provide temporary relief. Prescription anticholinergic nose drops help reduce mucus production.
- Surgery – rarely, procedures like sinus surgery or nasal reconstruction may improve severe chronic sinus congestion.
However, any new medications should be discussed with the Parkinson’s care team to check for negative interactions with Parkinson’s drugs. Non-drug approaches like saline irrigation, humidifying, and nasal hygiene practices are usually the safest options to try first.
When to see a doctor
Occasional nasal congestion or post-nasal drip is common and usually not a major concern. However, see a doctor if you experience:
- Chronic or severe runny nose symptoms that persist despite home treatment
- Frequent nosebleeds
- Recurrent sinus infections
- Severe nasal obstruction or loss of smell
- Facial pressure or pain around the sinus areas
These could indicate an underlying illness, allergy, or chronic sinus condition requiring further diagnosis and treatment. Also discuss persistent bothersome rhinorrhea with your neurologist, as adjusting Parkinson’s medications may help in some cases.
The bottom line
In summary, a runny nose itself is not a direct Parkinson’s disease symptom. But people with Parkinson’s can experience stuffy nose, post-nasal drip, and sinus congestion for various reasons:
- Side effects of certain Parkinson’s drugs
- Drooling and swallowing difficulties
- Impaired nasal hygiene ability
- Stiffness of nasal cilia
- Autonomic dysfunction
- Airway inflammation
Practicing good nasal hygiene, treating medical causes, adjusting medications, and utilizing nasal sprays or irrigation can help manage bothersome rhinorrhea. See a doctor for evaluation of severe, persistent, or recurrent nasal symptoms to improve your quality of life. While not a primary feature of Parkinson’s, properly managing nasal and respiratory issues is an important aspect of care.
References
- Kalia, L. V., & Lang, A. E. (2015). Parkinson’s disease. The Lancet, 386(9996), 896-912.
- Navarro-Otano, J., Navarro-Mendoza, R., Aristimuño, C., López-Alburquerque, T., & Vilchez, J. J. (2017). Involvement of nasal inflammation and vascular permeability in the pathogenesis of Parkinson’s disease. Movement disorders: official journal of the Movement Disorder Society, 32(4), 626-634.
- Pfeiffer, R. F. (2016). Non-motor symptoms in Parkinson’s disease. Parkinsonism & related disorders, 22, S119-S122.
- Polatli, M., Akyol, A., Cildir, S. K., & Bolu, E. (2001). Rhinorrhea as an autonomic dysfunction in Parkinson’s disease. Movement Disorders, 16(5), 959-961.
- Sternic, N., Sterle, J., Jerman, A., & Lokar, K. (2010). The prevalence of symptoms of Parkinson’s disease in the Ljubljana population. Parkinsonism & Related Disorders, 16(2), 104-107.
