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Parkinsons disease / Donald Grosset ... [et al.]. — London : Manson, 2009. – (64.148/P247) |
Contents
Contents
Contributors 5
Introduction 6
CHAPTER 1 Parkinson's disease facts and figures
History 9
Epidemiology 9
Survival 10
Causes 11
Risk factors 11
Genetic factors 12
Environmental factors 15
Protective factors 17
Disease progression 18
Pathophysiology 20
Neuropathology 22
Causes of neurone death 23
CHAPTER 2 Clinical diagnosis of parkinsonism and tremor 25
Symptom development 25
Clinical features 25
Bradykinesia 28
Asymmetry 28
Rigidity 31
Tremor 32
Postural instability 33
Frontal lobe reflexes 34
Subtypes of idiopathic PD 34
Problems in diagnosis 35
Other similar presentations 36
Red flags (alerts) 43
Misdiagnosis 44
CHAPTER 3 Diagnostic testing and neuroimaging 45
Dopaminergic challenge tests 45
Olfactory testing 46
Structural neuroimaging 46
Functional neuroimaging 50
Mechanisms in functional neuroimaging 50
Presynaptic dopamine imaging as a diagnostic and research tool in PD 52
Postsynaptic dopamine imaging in parkinsonism 54
Other types of functional neuroimaging in PD 55
Functional neuroimaging in clinical drug trials 55
Vascular parkinsonism and functional neuroimaging 56
Clinical applications of functional neuroimaging 56
Transcranial ultrasound 57
Cardiac sympathetic nerve imaging 57
Tremor recording 57
CHAPTER 4 Drug treatment of Parkinson's disease 59
Management principles 59
When to increase or add in therapy 59
Signs of overtreatment 59
Levodopa 60
COMT inhibitors 62
Dopamine agonists 63
Monoamine oxidase inhibitors 66
Anticholinergics 67
Amantadine 67
Continuous dopaminergic stimulation 68
CHAPTER 5 Nonmotor features of Parkinson's disease 69
Cognitive impairment 69
Psychiatric complications 74
Behavioural dysfunction 77
Sleep disturbances 82
Autonomic dysfunction 84
CHAPTER 6 Motor and nonmotor assessment scales 89
Motor scales 89
Nonmotor scales 98
CHAPTER 7 Surgical therapy for Parkinson's disease 115
Surgical options for PD 115
Selecting candidates for DBS or lesion surgery 116
Factors which may improve the success of PD surgery 118
Choosing a type of surgery and target site 119
DBS targeting and lead placement 120
Mapping the GPi 122
Microelectrode localization of the subthalamus 122
DBS lead implantation 122
DBS programming: general concepts 123
Programming DBS devices 123
Postoperative care 124
Risks of DBS 124
CHAPTER 8 The role of the nurse practitioner/ physician assistant 125
Introduction 125
Examining the PD patient 125
Coordinating care 127
Specialized services 129
Care of DBS patients 132
CHAPTER 9 The role of the physical and occupational therapist 133
Movement and functional deficits in the PD patient 133
Referral to a therapist 134
Limitations of therapy 134
Role of the physical therapist 135
Effects of medication on movment dysfunction 137
Effects of surgical intervention on movement dysfunction 138
Role of the occupational therapist 138
Social/emotional concerns and carer support 140
CHAPTER I 0 The role of the speech-language pathologist/therapist 141
Introduction 141
Communication disorders in PD 141
Causes of communication disorders 142
Evaluation and treatment of communication disorders 143
Swallowing disorders in PD 144
Causes of dysphagia in PD 145
Evaluation and treatment of swallowing problems 145
CHAPTER II Malnutrition and related disorders 147
Nutritional health and the role of the registered dietician 147
Nutritional disorders related to autonomic effects of PD 147
Nutritional disorders related to mental aspects of PD 149
Other effects of PD on nutritional health 151
Effects of PD medication 152
CHAPTER 12 Complementary medicine and Parkinson's disease 155
Introduction 155
Acupuncture 155
Massage therapy 156
Tai chi 157
Dietary supplements 157
Chelation therapy 159
Enhanced external counterpulsation 159
Resources 160
Further reading 162
Glossary 166
Index 170
Abbreviations 176
