Parkinson's disease is a neurodegenerative disease characterized by a loss of dopaminergic neurons in the substantia nigra pars compacta. Motor symptoms include bradykinesia, rigidity, and tremor. Treatment of motor symptoms focuses on reducing these symptoms while minimizing short-term side effects and avoiding long-term motor complications (motor fluctuations and dyskinesia). Nonmotor symptoms include cognitive dysfunction, sleep disorders, fatigue, depression, and autonomic abnormalities. Treatment of nonmotor symptoms focuses on specific symptomatic therapy. Currently no treatment has been proven to slow progression of Parkinson's disease, but this is an area of active research.
A series of cases throughout the chapter represents a progression of disease severity and treatment complexity.