title: [Therapy options in the case of advanced therapy resistant Morbus Parkinson].
abstract: In Germany about 300,000 to 400,000 people are suffering from Morbus Parkinson at present. It is one of the most common neurological diseases both in Germany and in Europe as a whole. With the rising number of elderly people in our population, the number of Parkinson patients will strongly increase as well in future. About 20% of these patients are already in an advanced stage. This stage leaves its marks with motor and non-motor sequelae. With the minority of these patients oral medication is ineffective. For these relatively rare cases an indication for an L-dopa-infusion therapy (duodopa pump), an apomorphine pump therapy or a deep brain stimulation may exist. The indication for one of these 3 therapy forms is given by the neurological clinic in agreement with the patient and is only given in case of failure of oral medication. All 3 therapy options are very expensive. In case of the deep brain stimulation, close cooperation between the neurologist and the neurosurgeon as well as with the patient is necessary. Experts warn about a transplantation of stem cells because there are no clinical studies and only partial clinical improvement with severe side effects are known. The transplantation of stem cells for advanced Morbus Parkinson is not a medically necessary treatment at present.
authors.affiliation: HALLESCHE Krankenversicherung, Stuttgart.
authors.forename: R
authors.initials: R
authors.lastname: Hakimi
mesh_terms: D000284:Administration, Oral; D000978:Antiparkinson Agents / Q000008:administration & dosage*; D001058:Apomorphine / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D046690:Deep Brain Stimulation; D004351:Drug Resistance; D006801:Humans; D015918:Infusion Pumps, Implantable; D007980:Levodopa / Q000008:administration & dosage; D009460:Neurologic Examination / Q000187:drug effects; D010300:Parkinson Disease / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D011157:Population Dynamics
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa; D001058:Apomorphine