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Parkinson Disease

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Parkinson disease (PD) is a progressive neurodegenerative disorder caused by degeneration of dopaminergic neurons in the substantia nigra pars compacta.

  • Cardinal symptoms include rest...

DIAGNOSIS

  • Diagnosis is based on clinical features of bradykinesia, resting tremor, asymmetry of symptoms, and response to dopaminergic therapy.

  • Gold standard for diagnosis is neuropathologic exam.

  • Gener...

TREATMENT

GENERAL MEASURES

  • Multidisciplinary rehabilitation with standard physical and occupational therapy components to improve functional outcomes

  • Physiotherapy to help with gait reeducation, enhance...

ONGOING CARE

DIET

  • Increase dietary fluids and fiber and increase activity for constipation.

  • For dysphagia, consider soft food, swallowing evaluation, and increased time for meals.

  • Avoid large, high-fat m...

REFERENCES

1
Gazewood JD, Richards DR, Clebak K. Parkinson disease: an update. Am Fam Physician.  2013;87(4):267–273. [View Abstract on OvidMedline]
2
Nalls MA, Plagnol V, Hernandez DG, et al; and ...

ADDITIONAL READING

Macleod AD, Taylor KS, Counsell CE. Mortality in Parkinson’s disease: a systematic review and meta-analysis. Mov Disord.  2014;29(13):1615–1622. [View Abstract on OvidMedline]...

CODES

ICD10

  • G20 Parkinson’s disease

  • G21.9 Secondary parkinsonism, unspecified

  • G31.83 Dementia with Lewy bodies

  • G21.11 Neuroleptic induced parkinsonism

  • G21.19 Other drug induced secondary parkinsonism

ICD9

  • 33...

CLINICAL PEARLS

  • The classic description for PD is shaky, stiff, slow, and stumbling.

  • Emphasize the importance of exercise and movement to help preserve function.

  • Pharmacotherapeutic regimens need to be ...

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