What is Parkinson's Disease?
Parkinson's disease (PD) is a degenerative disorder of the central nervous system characterized by the clinically asymmetric onset of resting tremor, bradykinesia, rigidity and postural instability. 1-3
Parkinson's disease (PD) is the second most common neurodegenerative disorder, after Alzheimer's disease.1,2
Diagnosis for Parkinson's disease
The most recent and comprehensive clinical guidelines for the diagnosis and management of Parkinson's disease (PD) in primary and secondary care have been compiled by the UK National Institute for Health and Clinical Excellence (NICE).4
A diagnosis of Parkinson's disease (PD) can be difficult as, in common with other central nervous system degenerative disorders, PD begins insidiously.
The severity of Parkinson's disease (PD) can be assessed using a number of rating scales, assessing patients' motor function, activities of daily living (ADL), mental status, dependency and complications of therapy.
Treatment of Parkinson's Disease
It is important that patients with Parkinson's disease (PD) are treated as soon as a full diagnosis has been made; several studies have shown that patients who receive effective symptomatic treatment earlier in the course of their disease fare significantly better clinically than patients who delay their treatment.5-7
It is not possible to identify a universal first-choice drug therapy for patients with early PD.8 In Established/advanced Parkinson's disease9 therapy choices need to be re-evaluated.
1. de Lau, L.M. and M.M. Breteler, Epidemiology of Parkinson's disease. Lancet Neurol, 2006. 5(6): p. 525-35.
2. Schapira, A.H., Science, medicine, and the future: Parkinson's disease. BMJ, 1999. 318(7179): p. 311-4.
3. Guttman, M., S.J. Kish, and Y. Furukawa, Current concepts in the diagnosis and management of Parkinson's disease. CMAJ, 2003. 168(3): p. 293-301.
4. NICE, N.I.f.H.a.C.E., NICE clinical guideline: Parkinson's disease: diagnosis and management in primary and secondary care. 2006.
5. Schapira, A.H. and J. Obeso, Timing of treatment initiation in Parkinson's disease: a need for reappraisal? Ann Neurol, 2006. 59(3): p. 559-62.
6. Poewe, W.H. and G.K. Wenning, The natural history of Parkinson's disease. Neurology, 1996. 47(6 Suppl 3): p. S146-52.
7. Rajput, A.H., Levodopa prolongs life expectancy and is non-toxic to substantia nigra. Parkinsonism Relat Disord, 2001. 8(2): p. 95-100.
8. Horstink, M., et al., Review of the therapeutic management of Parkinson's disease. Report of a joint task force of the European Federation of Neurological Societies and the Movement Disorder Society-European Section. Part I: early (uncomplicated) Parkinson's disease. Eur J Neurol, 2006a. 13(11): p. 1170-85.
9. Horstink, M., et al., Review of the therapeutic management of Parkinson's disease. Report of a joint task force of the European Federation of Neurological Societies (EFNS) and the Movement Disorder Society-European Section (MDS-ES). Part II: late (complicated) Parkinson's disease. Eur J Neurol, 2006b. 13(11): p. 1186-202