Parkinson's disease

doi:10.1136/bmj.39289.437454.AD

BMJ 2007;335:441-445 (1 September), doi:10.1136/bmj.39289.437454.AD

Clinical Review

Parkinson's disease

C E Clarke, professor of clinical neurology, University of Birmingham

Department of Neurology, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham B18 7QH

c.e.clarke@bham.ac.uk

The first 150 words of the full text of this article appear below.

• Parkinson's disease should be suspectedin someone with tremor, stiffness, slowness, balance problems,or gait disorders

• All patients with suspected Parkinson'sdisease should be referred untreated to a specialist in differentialdiagnosis and be reviewed regularly by the specialist for accuratediagnosis and treatment

• Much debate surrounds whichdrug class should be used as initial treatment for Parkinson'sdisease and which adjuvant therapy should be added when patientstaking levodopa develop motor complications

• Patientsshould have access to a Parkinson's disease nurse specialistand allied health professionals throughout the course of thedisease

Tremor, often combined with slowness and stiffness in an arm,presents frequently in general practice. It may be caused byessential tremor, which affects 2-3% of the population.¹ Parkinson'sdisease is less common (prevalence 0.2%), although its prevalence increases with age (4% of those aged over 80 years).² Differentiatingessential tremor from Parkinson's . . . [Full text of this article]

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