Dementia Rating Scale DRS

This instrument is used to assess dementia in a wide range of neuropsychological conditions. It was originally developed to assess change in cognition in patients with dementia, but can be used to screen for dementia. The scale is divided into five subsections O Attention. Initiation perseveration. Construction. Conceptualization. Memory. The scale takes about 20-30 minutes to complete. The maximum score is 144, with one point awarded for each task that is correctly performed. In tire revised...

Tolcapone

Another predominantly peripherally acting COMT inhibitor, indicated for wearing off symptoms of PD. Available in two doses 100 mg and 200 mg (USA only). It has a longer half-life than entacapone and is recommended to be taken no more than three times daily. May also cause diarrhoea generally after 1 month often requiring discontinuation of the drug. There have been three reported cases of acute liver failure potentially associated with tolcapone use. Therefore, frequent monitoring of liver...

R

Normal putamen and caudate activity is seen in the postsynaptic system in PD (a). This differs from presynaptic dopamine activity, which is abnormal in PD. Abnormal (reduced) activity is seen postsy-naptically in conditions such as multiple system atrophy (b). However these changes are more evident in later stage disease. In routine clinical practice, postsynaptic dopamine imaging does not reliably distinguish conditions such as MSA from PD. O A positive...

Parkinson Psychosis Rating Scale PPRS

This is the first scale aimed only at measuring psychotic symptoms in PD, and it correlates with other, accepted scales for the measurement of psychosis. Patients are scored 1 (absent) to 4 (severe) on the following six items O Visual hallucinations. O Illusions and misidentification of persons. O Paranoid ideation. O Sleep disturbances. O Confusion. O Sexual preoccupation. In addition, a Global Functional Impairment score is measured from the carer report. Each severity term is described for...

Contributors

Grosset, BSc MBChB MD FRCP Consultant Neurologist Katherine A. Grosset, MBChB MRCGP(1989) MD Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK Hubert H. Fernandez, MD Michael S.Okun,MD McKnight Brain Institute, University of Florida, Movement Disorders Fellow Joseph H. Friedman, MD Department of Clinical Neurosciences, Brown Medical School, NeuroHealth Parkinson's Disease and Movement Disorders Center, Warwick, Rhode Island, USA Department of Psychiatry and...

Parkinsons disease facts and figures

Parkinson's disease (PD) was first formally described by James Parkinson in an 1817 report (earlier records include a Shakespeare character with the condition). He described tremor, gait disorder, and brady-kinesia which he confused with paralysis, contributing to the misnomer 'paralysis agitans'. He was a general practitioner in Shoreditch, England. His observations were based on six cases - two of whom he met in the street and one of whom he had only seen from a distance. Prevalence of...

Introduction

The use of complementary therapies by PD patients is very common. Rajendran et al. (2001) found that 40 of PD patients surveyed used complementary therapies including vitamins, herbs, massage, and acupuncture. Little scientific evidence exists regarding the safety and efficacy of most of these alternative treatments for PD. A conservative estimate is that, in 1997, out-of-pocket expenditures for complementary medicine for PD patients in the USA was 27 billion. The use of herbal remedies and...

National support organizations

E norman.marshall parkinsonsaustralia. org.au Parkinson's Society Rio de Janeiro Av. Bosque da Saude 1.155 - Sao Paulo t f 011 578 8177 e asparkin netway.com.br w www.parkinson.org.br e pavel.kner email.cz w www.parkinson-cz.net Kirke V rlosevej 26-1 Verlose 3500 t +45 39 27 15 55 f +45 39 18 20 75 e dansk parkinson.dk w www.parkinson.dk Suomen Parkinson-liittory The Finnish ParkinsonAssociation Erityisosaamiskeskus Suvituuli (Rehabilitation Centre) Suvilinnantie 2 PL 905 Turku 20101 t1 +358 2...

Continuous dopaminergic stimulation

Duodopa Pump Dutch

Natural dopamine is released constantly without significant day-night (diurnal) variations. Dopamine replacement therapy should ideally replicate this, but the short duration of levodopa when given orally does not fulfil this need. Oral DAs have a longer duration of action, and help to smooth out the motor fluctuations inherent to levodopa therapy. Longer-acting oral DAs (e.g. ropinirole prolonged release) allow once-daily dosing, while transdermal, subcutaneous, and enteral routes (levodopa as...

Drug treatment of Parkinsons disease

Parkinson Prevention

Currently available drug treatments provide symptomatic benefit none is proven as neuroprotective. Treatment is initiated when required from a functional viewpoint (this is variable between patients, and the decision requires patient and often carer input). Treatment is started at a variable point after the onset of symptoms (note symptom onset usually predates diagnosis). There are several initial treatment choices, each with advantages and disadvantages. The main choices are levodopa (with...

Excessive daytime sleepiness

The reasons for EDS in PD are multifactorial and include effects of PD motor disability the disease process side-effects of dopaminergic medications co-morbidities (e.g. depression). Even low dosages may be sedating and induce sleep, whereas high dosages may prolong sleep latency and cause sleep disruption. EDS is found in 15-20 of PD patients compared to 1 of elderly individuals. The Epworth Sleepiness Scale is a subjective scale widely used in PD sleep studies. Sudden-onset sleep ('sleep...

Diagnostic testing and neuroimaging

Levodopa and apomorphine challenge tests may help to determine whether a patient is responsive to dopaminergic therapy (40). Levodopa challenge score the patient before and 60 min after a single high dose of levodopa (e.g. 250 mg). (Levodopa is given in the usual way in conjunction with a dopa-decarboxylase inhibitor, as Sinemet (co-careldopa) or Madopar (co-beneldopa), in a standard-release formulation). Apomorphine challenge score the patient before and 20 minutes after sequential doses of...