[Diagnosis and therapy of idiopathic Parkinson's disease].
The diagnosis of idiopathic Parkinson's disease is based on a thorough clinical examination with demonstration of the presence of bradykinesia, as well as tremor, rigidity, postural instability and hyposmia. Symptomatic forms and atypical Parkinson syndrome should be ruled out. Nuclear medical analyses of the dopamine metabolism and the dopamine receptors are used only in exceptions to clarify difficult cases of differential diagnoses. For young patients, dopamine-agonists and, indeed, once again increasingly MAO-B inhibitors, such as rasagiline, are mainly used for therapy. Older patients und patients in advanced stages receive levodopa and a COMT inhibitor. As supplemental therapy, amantadine is given for dyskinesia and apathy and budipine is given for tremor-dominant type of Parkinson's disease. In advanced stages with motor fluctuations, apomorphine or Duodopa pumps or deep brain stimulation are employed.
Reichmann
Heinz
H
Klinik und Poliklinik für Neurologie, Technische Universität Dresden. Heinz.Reichmann@mailbox.tu-dresden.de
D000328:Adult; D000368:Aged; D001058:Apomorphine; D046690:Deep Brain Stimulation; D003937:Diagnosis, Differential; D018491:Dopamine Agonists / Q000627:therapeutic use; D006801:Humans; D007189:Indans / Q000627:therapeutic use; D007980:Levodopa / Q000627:therapeutic use; D008609:Mental Status Schedule; D008996:Monoamine Oxidase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D018696:Neuroprotective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D010300:Parkinson Disease / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy
D018491:Dopamine Agonists; D007189:Indans; D008996:Monoamine Oxidase Inhibitors; D018696:Neuroprotective Agents; C031967:rasagiline; D007980:Levodopa; D001058:Apomorphine