Anaesthesia and Parkinson's disease: how to manage with new therapies?
OBJECTIVE
Parkinson's disease is the second most prevalent neurodegenerative disease and presents a particular anaesthetic challenge. The clinical features are described in detail, and recent advances in medical management and neurosurgical treatment options are highlighted.


RESULTS
Deep brain stimulation (DBS) has experienced a renaissance for selected patients. Potential drug interactions with anaesthetics are described and recommendations are made about suitable anaesthetic techniques, especially for DBS. In addition to the classic DBS in an awake state, stimulation under modified general anaesthesia seems possible in selected patients who are not suitable for awake craniotomy.


CONCLUSIONS
DBS is an attractive option for severely disabled patients with Parkinson's disease who pose a particular anaesthetic challenge.
Kalenka
Armin
A
Department of Anaesthesiology and Surgical Intensive Care Medicine, University Medical Center Mannheim, Theodor Kutzer Ufer 1-3, Mannheim 68167, Germany. armin.kalenka@urz.uni-hd.de
Schwarz
Anke
A