1. [Motor symptoms in Parkinson disease].
- Author
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Larsen JP, Beiske AG, Bekkelund SI, Dietrichs E, Tysnes OB, Vilming ST, and Aasly JO
- Subjects
- Age Factors, Antiparkinson Agents administration & dosage, Antiparkinson Agents therapeutic use, Deep Brain Stimulation, Dopamine Agonists administration & dosage, Dopamine Agonists therapeutic use, Dyskinesias complications, Dyskinesias drug therapy, Dystonia diagnosis, Dystonia drug therapy, Humans, Levodopa administration & dosage, Levodopa therapeutic use, Muscle Rigidity diagnosis, Muscle Rigidity drug therapy, Parkinson Disease complications, Parkinson Disease diagnosis, Parkinson Disease drug therapy, Selegiline administration & dosage, Selegiline therapeutic use, Treatment Outcome, Tremor diagnosis, Tremor drug therapy, Dyskinesias diagnosis, Parkinson Disease physiopathology
- Abstract
Background: Early Parkinson's disease is dominated by a motor syndrome called parkinsonism, but as the disease develops motor complications and non-motor problems may occur as well. This paper describes how to diagnose Parkinson's disease and the various motor complications and gives recommendations on how to treat the symptoms in these patients., Material and Methods: The paper builds on international evidence-based publications and the Norwegian guidelines for treatment of Parkinson's disease., Results and Interpretation: Motor symptoms such as tremor at rest, akinesia, rigidity and postural instability are the cardinal signs in Parkinson's disease. After diagnosing a patient with the disease we recommend to start with selegiline as a disease-modifying treatment strategy. When symptoms lead to functional impairment, symptomatic treatment should be started in addition. Dopamine agonists are primarily recommended in younger patients and levodopa in the older ones. When the patients develop motor complications it is important to first thoroughly evaluate the problems to arrive at the best possible treatment strategy. If a sufficient response is not obtained both deep brain stimulation and treatment with continuous delivery of medication should be considered.
- Published
- 2008