ABSTRACT
Progressive supranuclear palsy (PSP) is a heterogeneous progressive neurodegenerative disease characterized by onset after 50 years old, Parkinson's syndrome, early development of postural instability, absence or transient reaction to levodopa drugs, neuropsychological disorders, dysphagia and dysarthria and eye movement disorders. The review provides an analysis of modern data on etiology, clinical presentation, differential diagnosis of the disease. The morphological picture and neuroimaging features, as well as modern ideas about treatment, are described. A great clinical polymorphism of the disease, as well as its similarity to other neurodegenerative diseases, manifested by Parkinson's syndrome, complicates the diagnosis of PSP. Establishing an accurate diagnosis makes it possible to determine the prognosis and further tactics of patient management.
Subject(s)
Neurodegenerative Diseases , Parkinson Disease , Supranuclear Palsy, Progressive , Humans , Levodopa , Middle Aged , Neurodegenerative Diseases/diagnosis , Neuroimaging , Parkinson Disease/complications , Parkinson Disease/diagnosis , Parkinson Disease/drug therapy , Supranuclear Palsy, Progressive/diagnosisABSTRACT
In this article, we present clinical cases at an early stage of Parkinson's disease with mild affective and cognitive disorders, and at a later stage with motor fluctuations and levodopa-induced dyskinesia. The efficacy of dopamine receptor agonists in treatment of Parkinson's disease in the early and late stages is illustrated by the example of piribedil.
Subject(s)
Antiparkinson Agents/therapeutic use , Dopamine Agonists/therapeutic use , Parkinson Disease/drug therapy , Piribedil/therapeutic use , Dyskinesia, Drug-Induced/drug therapy , Dyskinesia, Drug-Induced/etiology , Female , Humans , Levodopa/adverse effects , Levodopa/therapeutic use , Middle Aged , Parkinson Disease/psychologyABSTRACT
Seventy-three patients with Parkinson's disease were enrolled. Patients were stratified into 2 groups by the presence (53 patients) or absence (20 patients) of nocturnal symptoms. A control group included 10 healthy people. The most frequent were the following symptoms: nocturia (71.8%), affective disorders (52.4%), akinesia (41.7%) and crampi (30.15%). These symptoms were more pronounced in akinetic/rigid form, greater severity and higher rate of progression of the disease. The positive therapeutic effect of stalevo on the above mentioned disorders was shown.
Subject(s)
Carbidopa/therapeutic use , Catechols/therapeutic use , Levodopa/therapeutic use , Parkinson Disease/diagnosis , Drug Combinations , Dyskinesias/diagnosis , Dyskinesias/drug therapy , Humans , Muscle Cramp/diagnosis , Muscle Cramp/drug therapy , Nocturia/diagnosis , Nocturia/drug therapy , Parkinson Disease/drug therapy , Restless Legs Syndrome/diagnosis , Restless Legs Syndrome/drug therapyABSTRACT
Nocturnal symptoms are integral part of the general clinical picture of Parkinson's disease (PD). They are subdivided into non-motor and motor symptoms, the latter included night akinesia, crampi, night akathisia, dystonia, restless leg syndrome (RLS), periodic movements of limbs (PML) and psychomotor agitation during sleep. We have studied 53 patients with PD and evaluated the frequency of these disturbances as follows: night akinesia (42.7%), crampi (31.1%), night akathisia (7.8%), RLS (5.8%), PML (3.8%). The symptoms were treated with the three-component drug stalevo in a single dose in the evening during 3 months. The dose was equivalent to that of levodopa prescribed to the patient earlier in the composition of a two-component drug. The significant reduction of nocturnal motor symptoms with the respective decrease in the frequency of emotional disorders, the improvement of daily activities and quality of life of patients were seen after the treatment.
Subject(s)
Antiparkinson Agents/therapeutic use , Carbidopa/therapeutic use , Catechols/therapeutic use , Dopamine Agents/therapeutic use , Levodopa/therapeutic use , Parkinson Disease/drug therapy , Sleep Disorders, Intrinsic/drug therapy , Aged , Antiparkinson Agents/administration & dosage , Carbidopa/administration & dosage , Catechols/administration & dosage , Dopamine Agents/administration & dosage , Drug Combinations , Female , Humans , Levodopa/administration & dosage , Male , Middle Aged , Parkinson Disease/physiopathology , Sleep Disorders, Intrinsic/physiopathologyABSTRACT
Based on literature data on the usage of Dopa medications in the treatment of Parkinson's disease (PD), a characteristic of a new complex drug stalevo, which includes levodopa, carbidopa and entacapon (catechol-O-methyltransferase inhibitor), is presented. The authors studied 15 patients with PD, aged 55.6+/-8.7 years, illness duration 7.7+/-3.1 years, who received stalevo during 6 weeks and revealed that stalevo reduced significantly the intensity of main PD symptoms, especially hypotension and rigidity as well as motor fluctuations, and improved general movement and daily activity of patients thus ameliorating their quality of life. The drug is well-tolerable.
