Year-end Sale % OFF 
Abstract
Parkinson’s disease (PD) is characterized by degeneration of dopaminergic neurons in the substantia nigra pars compacta and other neuronal populations. The worldwide prevalence of PD is over 7 million and has been increasing more rapidly than many other neurodegenerative disorders. PD symptoms can be broadly divided into motor (slowness, stiffness, tremor) and non-motor symptoms (such as depression, dementia, psychosis, orthostatic hypotension). Patients can also have prodromal symptoms of rapid eye movement sleep behavior disorder, hyposmia, and constipation. The diagnosis of PD is mainly clinical, but dopamine transporter single-photon emission computed tomography can improve the accuracy of the diagnosis. Dopamine based therapies are used for the treatment of motor symptoms. Non-motor symptoms are treated with other medications such as selective serotonin reuptake inhibitors (depression/anxiety), acetylcholinesterase inhibitors (dementia), and atypical antipsychotics (psychosis). Patients with motor fluctuations or uncontrolled tremor, benefit from deep brain stimulation. Levodopa-carbidopa intestinal gel is an alternative to deep brain stimulation for uncontrolled motor fluctuations. Rehabilitative therapies such as physical, occupational, and speech therapy are important during all stages of the disease. Management of PD is complex but there have been significant advancements in the treatment of motor and non-motor symptoms over the past few years. This review discusses the updates in the medical and surgical management of PD.
Highlights
Parkinson’s disease (PD) was first described by Dr James Parkinson in 1817 in his paper titled ‘Essay on the shaking palsy’ [1]
A higher proportion of patients in the dopamine agonist group (28%) and the monoamine oxidase B inhibitor group (23%) withdrew due to adverse effects compared to the levodopa group (2%)
Patients tend to experience the benefits of Deep brain stimulation (DBS) for even more than 10 years though some studies have reported that its effects on bradykinesia and rigidity may be limited to 5 years [109, 110]
Summary
Parkinson’s disease (PD) was first described by Dr James Parkinson in 1817 in his paper titled ‘Essay on the shaking palsy’ [1]. Patients have “off” periods when the effect of the medication wears off resulting in worsening of motor and non-motor symptoms [38]. Levodopa is the most potent medication for the treatment of motor symptoms of PD.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
