Parkinson Disease


Parkinson disease is a chronic neurodegenerative disease of the elderly resulting from damage to dopaminergic neurons in the substantia nigra. Environmental and genetic factors play a role.

Pathophysiology

Diagnosis

Treatment

  1. Anticholinergic agents reasonable 1st line
    1. Start small dose, gradually incr in strength/freq
    2. Benztropine mesylate, biperiden, trihexyhenidyl
  2. Add amantadine if these are inadequate
  3. If max tolerable dosages of both unsuccessful, discontinue and start levidopa-carbidopa
  4. Add bromocriptine to help manage on-off phenomenon & decr dose of levodopa
  5. Apomorphine and clozapine may be useful
  6. As DIP tremor may persist for years after discontinuation of drug, similar treatment as idiopathic Parkinson's dz
  7. Consider surgical management for severe disabling tremors after medical treatment has failed

 

Parkinson disease findings
TRAP
T
remor
Rigidity
Akinesia
Postural instability