Neurológia pre prax 6/2009

Postural instability in patients with Parkinson’s disease and its treatment

Postural instability (PI) is a cardinal sign of Parkinson’s disease (PD). Its importance increases along with the disease progression. Most serious consequences of PI are recurrent falls, which extremely worsen quality of patients´ life, and complications of which increase healthcare expenditures. Most of falls happens in patients’ home environment and in state of good mobility. Targeted history taking and specified clinical neurological assessment is needed to detect and follow-up PI. Pharmacotherapy has only limited effect. Drugs working predominantly through the noradrenergic neurotransmitter system seem to be promising. Long-term effect is expected from brain stimulation of the pedunculopontine nucleus. Continuous „tailored“ physiotherapy plays a key role in the treatment of PI and fall prevention in PD.

Keywords: postural instability, Parkinson’s disease, falls, treatment.