title: Understanding Parkinson's disease: detection and early disease management.
abstract: Parkinson's disease (PD) is a common, debilitating, neurodegenerative disorder characterized by neuronal loss within the basal ganglia and insufficient levels of the neurotransmitter dopamine. Symptoms include resting tremor, rigidity, bradykinesia (slowness of voluntary movement), and postural disturbances. Exact cause is unknown, but theories surrounding environmental or endogenous toxicities have been suggested. Differential diagnoses include genetic and other neurologic disorders that may share symptoms similar to those seen in PD. Clinical progression has been categorized into three phases of the disease: early, nonfluctuating, and fluctuating. Medications generally offer good symptom relief during the early and nonfluctuating phases of the disease. Classifications of anti-PD medications include anticholinergics, dopamine agonists, amantadine, MAO-B inhibitors, levodopa-carbidopa, and Catechol-o-methyl transferase inhibitors. Surgical intervention may be an option for select patients whose conditions are not well controlled though medical management strategies. Primary care providers often can manage patients in the early stage of PD, but later stages require expert neurologic management. Patient/family education and anticipatory guidance is imperative.
authors.affiliation: University of California, San Francisco School of Nursing, Department of Physiological Nursing, Gerontological Nurse Practitioner Program, 2 Kirkham Street, Box 0610, San Francisco, CA 94143-0610, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Mackin
mesh_terms: D000978:Antiparkinson Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D018450:Disease Progression; D006801:Humans; D010300:Parkinson Disease / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery
chemical_list: D000978:Antiparkinson Agents