Scharre D W, Mahler M E
UCLA School of Medicine.
Geriatrics. 1994 Oct;49(10):14-6, 20-3.
Parkinson's disease is a progressive neurodegenerative condition of unknown cause and with no known cure. The diagnosis is based on clinical findings of rest tremor, muscle rigidity, bradykinesia, and gait instability. Over 40% of patients develop a dementia syndrome that is largely distinct from Alzheimer's disease. Depression is common, also occurring in more than 40% of patients with PD. Careful evaluation in necessary to help distinguish Parkinson's disease from secondary causes of parkinsonism. Carbidopa/levodopa, dopamine agonists, and monoamine oxidase type B inhibitors are the mainstays of treatment. Anticholinergics and other agents may also be useful. Pharmacologic treatment must be carefully titrated to control symptoms and to avoid side effects. In advanced disease, dose-related dyskinesias, end-of-dose wearing-off effect, and unpredictable sudden motor fluctuations become very disabling and difficult to manage.
帕金森病是一种病因不明且无法治愈的进行性神经退行性疾病。其诊断基于静止性震颤、肌肉僵硬、运动迟缓及步态不稳等临床症状。超过40%的患者会发展出一种与阿尔茨海默病有很大区别的痴呆综合征。抑郁症也很常见，在超过40%的帕金森病患者中都会出现。进行仔细评估对于区分帕金森病和帕金森综合征的继发性病因很有必要。卡比多巴/左旋多巴、多巴胺激动剂和单胺氧化酶B型抑制剂是主要的治疗药物。抗胆碱能药物和其他药物可能也有用。必须仔细调整药物治疗剂量以控制症状并避免副作用。在疾病晚期，与剂量相关的运动障碍、剂末疗效减退和不可预测的突然运动波动会变得非常致残且难以控制。
