Parkinson disease: An update

John D. Gazewood, D. Roxanne Richards, Karl Clebak

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Parkinson disease is a progressive neurologic disorder afflicting approximately 1 percent of Americans older than 60 years. The cardinal features of Parkinson disease are bradykinesia, rigidity, tremor, and postural instability. There are a number of neurologic conditions that mimic the disease, making it difficult to diagnose in its early stages. Physicians who rarely diagnose Parkinson disease should refer patients suspected of having it to physicians with more experience in making the diagnosis, and should periodically reevaluate the accuracy of the diagnosis. Treatment is effective in reducing motor impairment and disability, and should be started when a patient begins to experience functional impairment. The combination of carbidopa and levodopa is the most effective treatment, but dopamine agonists and monoamine oxidase-B inhibitors are also effective, and are less likely to cause dyskinesias. For patients taking carbidopa/levodopa who have motor complications, adjunctive therapy with a dopamine agonist, a monoamine oxidase-B inhibitor, or a catechol O-methyltransferase inhibitor will improve motor symptoms and functional status, but with an increase in dyskinesias. Deep brain stimulation is effective in patients who have poorly controlled symptoms despite optimal medical therapy. Occupational, physical, and speech therapy improve patient function. Fatigue, sleep disturbances, dementia, and depression are common in patients with Parkinson disease. Although these conditions are associated with significantly lower quality of life, they may improve with treatment. (Am Fam Physician. 2013;87(4):267-273.

Original languageEnglish (US)
Pages (from-to)267-273
Number of pages7
JournalAmerican family physician
Volume87
Issue number4
StatePublished - Mar 15 2013

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Parkinson Disease
Monoamine Oxidase Inhibitors
Dopamine Agonists
Monoamine Oxidase
Dyskinesias
Physicians
Speech Therapy
Therapeutics
Hypokinesia
Deep Brain Stimulation
Occupational Therapy
Tremor
Nervous System Diseases
Nervous System
Fatigue
Dementia
Sleep
Quality of Life
Depression
levodopa drug combination carbidopa

All Science Journal Classification (ASJC) codes

  • Family Practice

Cite this

Gazewood, J. D., Richards, D. R., & Clebak, K. (2013). Parkinson disease: An update. American family physician, 87(4), 267-273.
Gazewood, John D. ; Richards, D. Roxanne ; Clebak, Karl. / Parkinson disease : An update. In: American family physician. 2013 ; Vol. 87, No. 4. pp. 267-273.
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Gazewood, JD, Richards, DR & Clebak, K 2013, 'Parkinson disease: An update', American family physician, vol. 87, no. 4, pp. 267-273.

Parkinson disease : An update. / Gazewood, John D.; Richards, D. Roxanne; Clebak, Karl.

In: American family physician, Vol. 87, No. 4, 15.03.2013, p. 267-273.

Research output: Contribution to journalArticle

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Gazewood JD, Richards DR, Clebak K. Parkinson disease: An update. American family physician. 2013 Mar 15;87(4):267-273.