[Diagnosis and treatment of Parkinson's syndrome. What is important for the general practitioner?].
The diagnosis of Parkinson's disease (PD) is clinical and is based on the identification of a combination of the cardinal motor signs of bradykinesia plus at least one of the following: rigidity, tremor or postural instability. There are many causes of parkinsonism such as drug induced parkinsonism, subcortical vascular disease, and multisystem atrophy. PD is a well characterised syndrome which represents only a part of the various causes of parkinsonism. A good response to dopaminergics is an important diagnostic criteria for PD. Pharmacotherapy for PD relies primarily on levodopa and dopamine agonists. Deep brain stimulation is increasingly used in the management of patients with severe dopa fluctuations and dyskinesias. Cholinesterase inhibitors are introduced for dementia in parkinsonism. Neuroprotective compounds, nerve growth factors such as GDNF and the implantation of dopaminergic cells are studied in clinical trials.
Ceballos-Baumann
A
A
Neurologische Klinik und Poliklinik, Klinikum rechts der Isar der TU München. a.ceballos@lrz.tum.de
D000368:Aged; D000547:Amantadine / Q000627:therapeutic use; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001058:Apomorphine / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D002396:Catechols / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003937:Diagnosis, Differential; D015259:Dopamine Agents / Q000627:therapeutic use; D018491:Dopamine Agonists / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D004876:Ergot Alkaloids / Q000627:therapeutic use; D005194:Family Practice; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D009570:Nitriles; D010300:Parkinson Disease / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D010302:Parkinson Disease, Secondary / Q000175:diagnosis / Q000188:drug therapy; D020734:Parkinsonian Disorders / Q000175:diagnosis / Q000188:drug therapy; D010880:Piperidines / Q000627:therapeutic use
D000978:Antiparkinson Agents; D002396:Catechols; D002800:Cholinesterase Inhibitors; D015259:Dopamine Agents; D018491:Dopamine Agonists; D004791:Enzyme Inhibitors; D004876:Ergot Alkaloids; D009570:Nitriles; D010880:Piperidines; D007980:Levodopa; C071192:entacapone; D000547:Amantadine; D001905:Botulinum Toxins; C026710:budipine; D001058:Apomorphine