Parkinsons

Please note - The EPG Parkinson's Knowledge Centre is for Doctors and other Healthcare Professionals. Enter the Parkinson's Knowledge Centre.

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}

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.

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.

Enter the Parkinson's Knowledge Centre

What’s in the Parkinsons Knowledge Centre?

• Parkinson's Disease Home
• Assessing Parkinson's disease severity
• Epidemiology
• Guidelines for diagnosing Parkinson's disease
• Making a diagnosis of Parkinson's disease
• Pathophysiology
• Amantadine
• Catechol-O-methyltransferase inhibitors
• Conventional levodopa
• Dopamine agonists
• Established/advanced Parkinson's disease
• Levodopa infusion
• Limitations with conventional levodopa therapy
• Making therapy choices (based on EFNS guidelines) - Early Parkinson's Disease
• Mode of action of anti-parkinsonian therapy
• Modification strategies for conventional levodopa
• Monoamine oxidase B inhibitors
• Potential Benefits of Early Optimisation of Levodopa Therapy
• References Cited
• Summary of Stalevo an optimized levodopa therapy
• Surgical Options
• Treatment options
• Congress Calendar
• Links
• Meetings reports
• Publications
• Announcements
• Building a Parkinson's disease patient-care team
• Contacts
• Diagnostic and patient assessment tools
• Information for healthcare professionals
• LEAP download section - ABPI
• Leap Downloads - Non ABPI
• Patient communication aids

References:
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.