McKinley James E, Perkins Allen
Crestwood Medical Center, 1 Hospital Drive Southwest, Huntsville, AL 35801.
University of South Alabama College of Medicine Department of Family Medicine, 1601 Center Street, 2N Mobile, AL 36604.
FP Essent. 2019 Feb;477:16-21.
Parkinson disease (PD) is a complex neurologic disorder that involves motor and nonmotor brain functions. PD is the second most common neurodegenerative disease after Alzheimer disease. Motor symptoms include resting tremor, cogwheel rigidity, extreme slowness of movement, shuffling gait, and impaired balance. Swallowing and speaking difficulties also are common. Nonmotor symptoms include depression, hallucinations, and sleep disturbances that seriously affect quality of life. There is no cure for PD but management of motor and nonmotor symptoms can improve quality of life. Carbidopa-levodopa is an effective initial treatment for motor symptoms of rigidity and resting tremors. Treatments for nonmotor symptoms include antidepressants, antipsychotics, and drugs for dementia. (This is an off-label use of some antidepressants, antipsychotics, and drugs for dementia.) A multidisciplinary approach to optimizing care can include physical and occupational therapy, speech therapy, and psychological therapy.
帕金森病(PD)是一种复杂的神经系统疾病,涉及运动和非运动脑功能。帕金森病是仅次于阿尔茨海默病的第二常见神经退行性疾病。运动症状包括静止性震颤、齿轮样强直、运动极度迟缓、拖步和平衡受损。吞咽和言语困难也很常见。非运动症状包括抑郁、幻觉和睡眠障碍,这些会严重影响生活质量。帕金森病无法治愈,但对运动和非运动症状的管理可以改善生活质量。卡比多巴-左旋多巴是治疗强直和静止性震颤等运动症状的有效初始治疗方法。非运动症状的治疗包括抗抑郁药、抗精神病药和治疗痴呆的药物。(这是一些抗抑郁药、抗精神病药和治疗痴呆药物的非适应证用药。)优化护理的多学科方法可包括物理治疗、职业治疗、言语治疗和心理治疗。