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Right arrow Parkinson's disease
CMAJ • February 4, 2003; 168 (3)
© 2003 Canadian Medical Association or its licensors

Review
Synthèse

Current concepts in the diagnosis and management of Parkinson's disease

Mark Guttman, Stephen J. Kish and Yoshiaki Furukawa

From the Departments of Medicine (Division of Neurology) (Guttman) and Psychiatry (Guttman, Kish, Furukawa), University of Toronto, Toronto, and the Movement Disorders Research Laboratory (Furukawa) and the Human Neurochemical Pathology Laboratory (all authors), Centre for Addiction and Mental Health, Toronto, Ont.

Correspondence to: Dr. Mark Guttman, 407–377 Church St., Markham ON L6B 1A1; fax 905 472-6270

Abstract

PARKINSON'S DISEASE IS A PROGRESSIVE NEUROLOGICAL disorder characterized by rest tremor, bradykinesia, rigidity and postural instability. The cause is unknown, but growing evidence suggests that it may be due to a combination of environmental and genetic factors. Treatment during the early stage of Parkinson's disease has evolved, and evidence suggests that dopamine agonist monotherapy may prevent the response fluctuations that are associated with disease progression. L-dopa therapy, however, remains the most efficacious treatment. Treatment during the advanced stage focuses on improving control of a number of specific clinical problems. Successful management of motor response fluctuations (e.g., "wearing off," on–off fluctuations, nighttime deterioration, early morning deterioration and dyskinesias) and of psychiatric problems is often possible with specific treatment strategies. Surgical treatment is an option for a defined patient population.




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Corrections
Can. Med. Assoc. J., March 4, 2003; 168(5): 544 - 544.
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