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Semin Neurol 2017; 37(02): 118-126
DOI: 10.1055/s-0037-1601888
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Diagnosis and Management of Parkinson's Disease

Arjun Tarakad
1   Department of Neurology, Parkinson's Disease Center and Movement Disorder Clinic, Baylor College of Medicine, Houston, Texas
,
Joseph Jankovic
1   Department of Neurology, Parkinson's Disease Center and Movement Disorder Clinic, Baylor College of Medicine, Houston, Texas
› Author Affiliations
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Publication History

Publication Date:
16 May 2017 (online)

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Abstract

Despite numerous efforts to identify specific and sensitive biomarkers, the diagnosis of Parkinson's disease (PD) is still based on clinical criteria that include the presence of a combination of cardinal motor features (tremor, rigidity, bradykinesia, and postural instability), other motor features (including freezing of gait and abnormal postures), and numerous nonmotor features. In addition, the presence of atypical features may suggest an alternative diagnosis. Levodopa therapy remains the gold standard in the management of motor features of PD. New formulations of levodopa and novel delivery systems are currently being evaluated and gradually introduced in clinical practice in an attempt to prevent or treat levodopa-related motor complications. Dopamine agonists also play an important role as monotherapy in mild or adjunctive therapy in moderately advanced disease. As the disease progresses and patients develop complications from levodopa therapy, specifically motor fluctuations and dyskinesias, deep brain stimulation becomes an alternative therapeutic option. Clinical trials of experimental therapeutics are currently fueling the PD therapeutic pipeline.

Keywords

Parkinson's disease - motor fluctuations - dyskinesia - levodopa - deep brain stimulation
 

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