DOPA-sparing strategy in the treatment of young onset Parkinson's disease.

CONTEXT: Late onset Parkinson's disease (LOPD) is a neurodegenerative disorder afflicting individuals of ages 60 and older. However, 5-10% of cases can begin earlier between the ages 20 to 40, and are classified as young onset Parkinson disease (YOPD). AIM: In turn, this study aims to observe the trend in the choice of drug administered to patients with both YOPD and LOPD, with particular emphasis on this trend in its relation to the practice background of the neurologist. SETTINGS AND DESIGN: A cross-sectional study was conducted in a community based Parkinson's disease and movement disorder clinic. STATISTICAL ANALYSIS USED: Using a retrospective chart review data was obtained and analysed. RESULTS: The results showed that 83% of general neurologists prescribed levodopa to their patients with YOPD, whereas movement-disorder specialists took a different approach altogether. They opted not to use levodopa and, in its stead, prescribed a mixture of alternate drugs.

Prevalence of essential tremor in an idiopathic Parkinson's disease patient population.

Essential tremor (ET) and Parkinson's disease (PD) tremor differ in type, frequency and distribution. Despite being two separate disorders, there have been cases reported of comorbidity for ET-PD. Studies have reported an increase in the incidence of ET in relatives of patients with PD, yet the risk of developing PD in ET patients has not been thoroughly investigated. Our study set out to determine the incidence of precedent ET in PD patients. We conducted a retrospective chart review analysis of 332 idiopathic PD patients to determine how many of them had ET prior to the diagnosis of PD and the percentage of them who were also diagnosed with ET. Our results indicate that the prevalence of precedent ET among a population of idiopathic PD patients was not any higher than the prevalence of ET in a comparable general population. Our results support the notion that ET and PD are mutually independent disorders. Further studies are needed to understand the exact relationship between these two disorders.

Factors associated with the development of impulse compulsive disorders in Parkinson patients.

OBJECTIVE: The aim of this study is to identify the prevalence of impulse compulsive disorder (ICD) in Parkinson's disease (PD) patients and to study potential associative factors that may be related to the onset of ICD while on parkinsonian medications. METHOD: The study was conducted in two parts. In Part A, the prevalence of ICD in 140 PD patients was first assessed, followed by identifying any common variables that may be associated with the development of ICD. Finally, using a detailed chart review, Part B of the study examined the prevalence of ICD in all patients who presented with identical risk factors gathered in Part A. RESULTS: Of the 140 patients, 8 patients developed symptoms of ICD. Seven of these patients were found to have five common variables that included gender (males), stages 1-2 of PD, young onset of PD, maximum dosage of the drug and the use of dopamine agonists (DAs). Of the 140 patients, 22 patients fit the above-mentioned five criteria and of those 22 patients, 33% developed symptoms of ICD. CONCLUSION: The use of DA therapy in the treatment of PD patients should be carefully monitored, especially in younger male patients who exhibit early signs of parkinsonian symptoms. As such, it is crucial for physicians to adjust DA dosages while also seeking alternative treatments to avoid the risk of ICD while on DAs.