GEM - Parkinson's disease including reference to NICE guidance

Parkinson's disease

Parkinson's disease is a disease of unknown aetiology which is characterised by:

• tremor
• bradykinesia
• rigidity
• impaired postural reflexes

Parkinson's disease is due to the degeneration of dopaminergic neurones in the substantia nigra.

How common is Parkinson's disease?

• GPN reference

What are the characteristic features of the Parkinsonian tremor?

• GPN reference

What are the features suggestive of an essential tremor?

• GPN reference

What are the main other clinical features of Parkinson's disease?

• GPN reference

When considering the diagnosis of Parkinson's disease, can you think of a differential diagnosis?

• GPN reference

If a general practitioner suspects possible Parkinson's disease, should the patient be referred for expert diagnosis and management, or treatment initiated by the general practitioner?

• GPN reference

In the management of early parkinson's disease, NICE has suggested that there is a choice of three different therapies as first-line treatment for early Parkinson's disease

• levo dopa
• monoamine oxidase type B inhibitors
• dopamine agonists

If psychotic symptoms develop in the patient with Parkinson's disease and antipsychotic medication is indicated, are typical or atypical antipsychotics preferred?

• GPN reference

Further information:

• GPnotebook section - Parkinson's disease

Reference:

1. Royal College of General Practitioners (August 2006). Curriculum Statement 15.7 Neurological problems.