PARKINSON’S DISEASE (PD) / ATYPICAL PARKINSONIAN SYNDROMES. CLINICAL AND THERAPEUTIC CARACTHERISTICS

Parkinson’s disease (PD) and other neurologic conditions are now the leading cause of health loss and disability around the world, affecting nearly half of the world's population. Affecting about 1% of population older than 60 years, the PD is among common neurologic disorders, which causes progressive disability that can only be slowed, but not cured, by treatment. Once patients display symptoms like rigidity, bradykinesia, or tremor it's most probably too late for neuroprotective therapy because 70% of the dopaminergic neurons are already dead. With early preclinical diagnosis, we should be able to identify the preclinical phase of Parkinson's disease and include these patients in future trials for neuroprotection. The goal of medical management of PD is to provide control of signs and symptoms for as long as possible while minimizing adverse effects. Several primary neurodegenerative disorders distinct from PD share parkinsonian features of bradykinesia, rigidity, tremor, and balance disturbances. All these disorders share common features of PD, thus being collectively named Parkinson-plus syndromes. An inadequate response to treatment in a patient with parkinsonian symptoms suggests the possibility of Parkinson-plus syndrome. Clinically, however, 4 separate Parkinson-plus syndromes have been identified, as follows: Multiple system atrophy (MSA), Progressive supranuclear palsy (PSP), Corticobasal ganglionic degeneration (CBD), Dementia with Lewy bodies (DLB).