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2020, Number 1

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Rev Cubana Neurol Neurocir 2020; 10 (1)

Diagnosis and medical treatment of the Parkinson's disease

Rodríguez GPL

Language: Spanish
References: 35
Page: 1-18
PDF size: 360.77 Kb.


ABSTRACT

Objective: To describe current approaches for the diagnosis and medical treatment of Parkinson's disease.
Evidence acquisition: A bibliographic review of different articles, in the last 5 years, on the diagnosis and treatment of Parkinson's disease was carried out in PubMed with the search term “Parkinson's disease AND diagnosis AND treatment”, with the filters: “Free full text, Guideline, Review, Humans, English, MEDLINE”. From the articles that addressed the same topic, those that were considered most relevant and topical were selected.
Results: Parkinson's disease is a heterogeneous disorder in its presentation and evolution. The criteria of the Movement Disorders Society are useful, for the diagnosis, such as: mandatory, supportive, exclusionary and red flags. These allow assessing two levels of diagnostic certainty: 1) Clinically established, and 2) Clinically probable. Several manifestations of the prodromal phase (biomarkers) can be identified before reaching a clinical diagnosis. The classification should include motor presentations (with predominance of tremor and with gait difficulty / postural instability) and clinical phenotypes (predominant light-motor, intermediate, diffuse malignant). Consultation with the Neurology specialist is important for the adequate treatment of the various motor, mental and autonomic symptoms.
Conclusions: The diagnosis of Parkinson's disease is essentially clinical based on the conjugation of several inclusion and exclusion criteria. Its classification has prognostic utility and allows the treatment to be individualized. The current treatment is essentially symptomatic and specialized, but it is necessary to deepen the evidence in this regard. The variety of clinical trials of emerging therapies focused on pathophysiological processes, establishes a potential for changes in the perspective provided and greater benefit in the future.


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