An approach to acute clinical deterioration in patients with late-stage Parkinson's disease.

Abstract

Idiopathic Parkinson's disease is a slowly progressive neurodegenerative disease. In the absence of disease-modifying therapies, patients inevitably progress to late-stage disease, characterised by a shift towards increasing disability from predominantly non-motor symptoms, which may be poorly levodopa responsive. The aim of this article is to provide generalpractitioners (GPs) with a practicalapproach to the diagnosis and management of acute clinical deterioration in patients with late-stage Parkinson's disease. The authors outline common causes for such change and an approach to their workup and management. With an ageing population, we are seeing an increased prevalence of Parkinson's disease at all stages. Neurologists, geriatricians and GPs alike should therefore be familiar with the syndrome of late-stage Parkinson's disease and be equipped with treatment strategies to address acute non-motor and motor deteriorations.