Parkinson's disease: aetiology, diagnosis, and management.

OBJECTIVE

To review the aetiology, diagnosis, and management of Parkinson's disease, with a local perspective.

DATA SOURCES

Medline from 1966 onwards, and all major neurological journals and movement disorder journals were searched for evidence on the aetiology, diagnosis, and management of Parkinson's disease.

STUDY SELECTION

Key words for the literature search were "Parkinson's disease" and "Chinese" or "Hong Kong".

DATA EXTRACTION

All relevant articles in English were reviewed.

DATA SYNTHESIS

The number of promising genes for familial Parkinson's disease is still expanding rapidly and there has been a wealth of studies on susceptibility genes for Parkinson's disease. Potential treatment choices include the use of agents thought to be neuroprotective, symptomatic treatment with drugs or surgery, and non-pharmacological treatments. Pharmacological treatment using a dopa-sparing strategy and continuous dopaminergic stimulation is now gaining support to address the issue of long-term motor complications. Surgical treatment with deep brain stimulation is safe and effective for refractory cases and has been increasingly utilised locally.

CONCLUSIONS

Medical therapy remains the mainstay of treatment and newer agents and treatment approaches are emerging, which will hopefully address the issue of neuroprotection and provide symptomatic treatment with fewer motor complications.