Premium
The Management of Parkinson's Disease
Author(s) -
Morris J. G. L.
Publication year - 1982
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1982.tb02460.x
Subject(s) - medicine , amantadine , levodopa , bromocriptine , anticholinergic , decarboxylase inhibitor , disease , parkinson's disease , anticholinergic agents , dementia , drug , anesthesia , physical medicine and rehabilitation , intensive care medicine , psychiatry , pharmacology , prolactin , hormone
Continuing education–state of the art. The management of Parkinson's Disease . J. G. L. Morris, Aust. N.Z. J. Med., 1982, 12, pp. 195–205. It is useful to divide Parkinsonian patients into those whose signs are confined to tremor, rigidity and akinesia, and those with evidence of a more diffuse disturbance. The treatment of choice in the former is levodopa combined with a peripheral decarboxylase inhibitor. At the onset of the disease, when disability is minimal, amantadine or anticholinergic drugs may suffice. Bromocriptine is useful in some patients who derive only short–lived benefit from each dose of levodopa. The role of stereotactic surgery is now confined to patients with an incapacitating unilateral tremor which has not improved with drug therapy. In elderly patients with evidence of diffuse cerebral dysfunction such as dementia, grasp reflex, hyper–reflexia or severe postural hypotension, the beneficial effect of these drugs is often outweighed by the side effects. Small doses of levodopa alone may be tried. Anti– cholinergic drugs and amantadine should be avoided in such patients.