Overview
Introduction
The practical challenge in Parkinson disease is not simply controlling tremor.
The practical challenge in Parkinson disease is not simply controlling tremor. A person may alternate between medication-responsive immobility and dyskinesia while dysphagia, orthostatic hypotension, hallucinations and cognitive change alter immediate risk. Parkinson disease is diagnosed clinically, then managed over time through treatment response, motor complications, non-motor symptoms and functional goals. Levodopa improves motor symptoms but does not slow disease progression, and missed dopaminergic doses can precipitate a neurological emergency. Advanced fluctuations that remain disabling despite optimized medication warrant referral to a movement disorder centre for consideration of device-aided therapy.