title: [Treatment possibilities in advanced Parkinson's disease].
abstract: In the course of Parkinson's disease, advanced and late stages can be distinguished. In the advanced stage, levodopa has good effect on motor symptoms, but patient care is often hindered by levodopa-induced complications such as motor fluctuation and dyskinesias. In the late stage levodopa response becomes poor, falls, dementia and psychotic symptoms appear and patients often need hospitalization. In the advanced stage, the quality of life may be improved better by device-aided therapy than by best oral medical treatment. The alternatives are apomorhin pump, levodopa carbidopa intestinal gel with pump and deep brain stimulation. The therapy plan should be based on the principle: "the right treatment, to the right patient, at the right time".
authors.affiliation: Semmelweis Egyetem, Neurológiai Klinika, Budapest. takannam@gmail.com
authors.forename: Annamária
authors.initials: A
authors.lastname: Takáts
authors.affiliation: Semmelweis Egyetem, Neurológiai Klinika, Budapest.
authors.forename: Helga
authors.initials: H
authors.lastname: Nagy
authors.affiliation: Semmelweis Egyetem, Neurológiai Klinika, Budapest.
authors.forename: Péter
authors.initials: P
authors.lastname: Radics
authors.affiliation: Semmelweis Egyetem, Neurológiai Klinika, Budapest.
authors.forename: Adrián
authors.initials: A
authors.lastname: Tóth
authors.affiliation: Semmelweis Egyetem, Neurológiai Klinika, Budapest.
authors.forename: Gertrúd
authors.initials: G
authors.lastname: Tamás
mesh_terms: D000284:Administration, Oral; D000367:Age Factors; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001058:Apomorphine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002230:Carbidopa / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control; D046690:Deep Brain Stimulation; D015259:Dopamine Agents / Q000627:therapeutic use; D004361:Drug Tolerance; D004386:Duodenum; D004409:Dyskinesia, Drug-Induced / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D005782:Gels; D006801:Humans; D015918:Infusion Pumps, Implantable; D007980:Levodopa / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D011788:Quality of Life; D012720:Severity of Illness Index
chemical_list: D000978:Antiparkinson Agents; D015259:Dopamine Agents; D005782:Gels; D007980:Levodopa; D002230:Carbidopa; D001058:Apomorphine
vernacular_title: Kezelési lehetoségek a Parkinson-kór elorehaladott stádiumában.