[Motor symptoms in Parkinson disease].
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.


METHODS
The paper builds on international evidence-based publications and the Norwegian guidelines for treatment of Parkinson's disease.


CONCLUSIONS
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.
Larsen
Jan Petter
JP
Nevrologisk avdeling, Stavanger universitetssjukehus, 4068 Stavanger. jpl@sus.no
Beiske
Antonie Giaever
AG
Bekkelund
Svein Ivar
SI
Dietrichs
Espen
E
Tysnes
Ole-Bjørn
OB
Vilming
Steinar T
ST
Aasly
Jan O
JO
D000367:Age Factors; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000627:therapeutic use; D046690:Deep Brain Stimulation; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D020820:Dyskinesias / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D004421:Dystonia / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage / Q000627:therapeutic use; D009127:Muscle Rigidity / Q000175:diagnosis / Q000188:drug therapy; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D012642:Selegiline / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D014202:Tremor / Q000175:diagnosis / Q000188:drug therapy
D000978:Antiparkinson Agents; D018491:Dopamine Agonists; D012642:Selegiline; D007980:Levodopa
Motoriske symptomer ved Parkinsons sykdom.