Neurológia pre prax 1/2013

Late complications of Parkinson's disease

Parkinson's disease is one of the most common neurodegenerative diseases. It manifests with a classic triad of symptoms (tremor, hypokinesia, and rigidity). Establishing the diagnosis may be challenging and frequently takes several months. Dopamine replacement therapy is an effective treatment. The treatment works very well in the first few years; afterwards, however, late complications start to develop and include both motor and mental as well as autonomic ones. The disease is complex and cannot be limited to motor symptoms only. In the late stages, non- -motor symptoms often affect the quality of life of the patient and his family more than motor symptoms do. The present paper aims to briefly describe the most important late complications of this condition. Each thematic section is concluded with brief therapeutic recommendations.

Keywords: Parkinson's disease, wearing off, dyskinesias, continuous dopaminergic stimulation, depression, cognitive deficit, psychotic complications.