Morris J G
Aust N Z J Med. 1982 Apr;12(2):195-205. doi: 10.1111/j.1445-5994.1982.tb02460.x.
It is useful to divide Parkinsonian patients into those whose signs are confined to tremor, rigidity and akinesia, and those with evidence of a more diffuse disturbance. The treatment of choice in the former is levodopa combined with a peripheral decarboxylase inhibitor. At the onset of the disease, when disability is minimal, amantadine or anticholinergic drugs may suffice. Bromocriptine is useful in some patients who derive only short-lived benefit from each dose of levodopa. The role of stereotactic surgery is now confined to patients with an incapacitating unilateral tremor which has not improved with drug therapy. In elderly patients with evidence of diffuse cerebral dysfunction such as dementia, grasp reflex, hyper-reflexia or severe postural hypotension, the beneficial effect of these drugs is often outweighed by the side effects. Small doses of levodopa alone may be tried. Anticholinergic drugs and amantadine should be avoided in such patients.
将帕金森病患者分为两类是有用的，一类患者的症状仅限于震颤、僵直和运动不能，另一类患者有更广泛功能障碍的证据。前者的首选治疗方法是左旋多巴联合外周脱羧酶抑制剂。在疾病初期，当残疾程度很小时，金刚烷胺或抗胆碱能药物可能就足够了。溴隐亭对一些从每剂左旋多巴中仅获得短暂益处的患者有用。立体定向手术现在仅限于药物治疗后无改善的致残性单侧震颤患者。在有弥漫性脑功能障碍证据的老年患者中，如痴呆、抓握反射、反射亢进或严重体位性低血压，这些药物的副作用往往超过其有益效果。可以尝试单独使用小剂量左旋多巴。这类患者应避免使用抗胆碱能药物和金刚烷胺。
