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Parkinson Disease

Sireesha Teegala, MD, Arlene Reyes, MD and Fozia Akhtar Ali, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Parkinson disease (PD) is a progressive neurodegenerative disorder caused by loss of dopaminergic neurons in the substantia nigra pars compacta as well as other dopaminergic regions ...

DIAGNOSIS

  • Diagnosis is based on clinical features and response to dopaminergic therapy.

  • Gold standard for diagnosis is neuropathologic exam.

  • Generally, bradykinesia plus either tremor or rigidity must b...

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 for constipation.

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

  • Avoid large, high-fat meals that slow digesti...

REFERENCES

1
Diaz NL, Waters CH. Current strategies in the treatment of Parkinson’s disease and a personalized approach to management. Expert Rev Neurother.  2009;9(12):1781–1789. [View Abstract o...

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 (pill-rolling tremor at rest), stiff (cogwheel rigidity), slow (bradykinesia), and stumbling (shuffling gait).

  • No cure—goals are to delay disease...

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