Pathophysiology
The goal of therapy is to reduce movement dysfunction while managing cognitive changes.1,3 Episodes of poor movement, including worsening rigidity, tremors, and slowness, may be referred to as an “off” period. An “on” period, conversely, refers to functional movement, when medication controls motor symptoms. The most effective pharmacologic therapy for symptomatic treatment of severe disease and “off” periods includes dopaminergic agents, specifically, levodopa, a precursor to dopamine, given with carbidopa, which reduces peripheral conversion of levodopa to dopamine. Monoamine oxidase type B (MAO-B) inhibitors and non-ergot dopamine agonists are effective as monotherapy in mild to moderate symptomatic PD. Dopaminergic agents are to be used first-line in combatting motor and nonmotor symptoms.
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Examination
Investigations
Treatment
Golden pearls
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