PARKINSON'S DISEASE: ETIOLOGY AND TREATMENT

Oksana Suchowersky; Sarah Furtado Movement Disorders p. 15-41 June 2004, Vol.10, No.3 doi: 10.1212/01.CON.0000293565.71963.bd
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This chapter reviews etiology, clinical features, and treatment of Parkinson's disease (PD). The functional neuroanatomy of the basal ganglia in PD is described. Several genetic mutations that result in PD have been discovered; of these, parkin may be relatively common and thus of greatest clinical importance. Coffee/caffeine consumption, smoking, and pesticide exposure are reliably associated with the risk for developing PD. The etiology of PD is currently viewed as a combination of environmental and genetic factors.

The diagnosis of PD is a clinical one; other neurodegenerative and secondary causes of parkinsonism need to be considered. Treatment is symptomatic; no neuroprotective therapies currently exist. In the early stages, monotherapy is recommended, but with disease progression combination therapy is useful. Surgery is an option for patients who become less responsive to medical therapy. In advanced disease, nonmotor symptoms such as autonomic dysfunction and dementia play a significant role in disability.

© 2004 American Academy of Neurology