BMJ Best Practice Podcast Parkinson’s disease
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Oct 7, 2022 Delaram Safarpour, an Assistant Professor of Neurology at Oregon Health & Science University, dives into the complexities of Parkinson's disease. She outlines how it presents with both motor and non-motor symptoms, including key diagnostic signs and the importance of careful patient history. Delaram discusses the role of levodopa and the trade-offs with dopamine agonists, alongside treatment for associated issues like depression and cognitive decline. Practical advice on managing symptoms and recognizing atypical syndromes rounds out her insights.
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Parkinson's Is More Than A Movement Disorder
- Parkinson's disease is a clinical syndrome with both motor and non-motor symptoms that shape patients' lives.
- Non-motor features like constipation, depression and anosmia can precede motor signs by years and affect quality of life more than movement problems.
Look For Red Flags During Assessment
- Take a detailed history and look for red flags like early falls, early autonomic failure or early cognitive change.
- If red flags exist, consider atypical Parkinsonism (e.g., MSA, PSP) rather than idiopathic Parkinson's disease.
Unilateral Onset Doesn't Confirm Idiopathic Parkinson's
- Parkinson's motor symptoms can begin unilaterally or bilaterally and this alone rarely distinguishes typical from atypical cases.
- Use broader clinical features and progression rather than lateralisation to guide diagnosis.