- 3 cardinal signs : resting tremor, rigidity and bradykinesia
- 2 of 3 including bradykinesia are required to make a clinical diagnosis
- medical therapy of PD
~ Levodopa
- for older patient
- risk risk of disease acceleration and motor fluctuations & dyskinesia
~ Dopamine agonist (ropinirole, pramipexole)
- for younger patients
- used as monotherapy to delay starting L-dopa in early stage of PD
- lower risk of dyskinesia
~ COMT inhibitor (entacapone)
~ MAO-B inhibitor (selegiline)
~ anticholinergic (benzhexol) - improve tremor and sialorrhea
~ apomorphine
- DaT (dopamine transporter) scan helps to differentiate PD from essential tremor
- deep brain stimulation or pallidotomy when medical therapy fails
4 comments:
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