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Author: J. Eric Ahlskog, PhD, MD Publisher: Oxford University Press ISBN: 0190231882 Category : Health & Fitness Languages : en Pages : 545
Book Description
The fundamental guide to the most effective treatments for Parkinson's Disease, from a Mayo Clinic doctor with thirty years of clinical and research experience. In this second edition follow-up to the extremely successful first edition, Dr. Ahlskog draws on thirty years of clinical experience to present the definitive guide to dealing with all aspects of Parkinson's Disease, from treatment options and side effects to the impact of the disease on caregivers and family. Dr. Ahlskog's goal is to educate patients so that they can better team up with their doctors to do battle with the disease, streamlining the decision-making process and enhancing their treatment. To do this, Dr. Ahlskog offers a gold mine of information, distilled from his years of experience treating people with Parkinson's at the Mayo Clinic. In addition to providing a comprehensive account of Parkinson's medications, this book also examines additional aspects of treatment, such as the role of nutrition, exercise, and physical therapy. Although many commendable texts have been written on the subject of Parkinson's Disease, their discussions of treatment have not been in depth. Dr. Ahlskog sifts through aspects of the disease in order to give the reader a comprehensive sense of Parkinson's and the best available treatment options. With a broader understanding of the disease and the available options, patients are able to make more informed choices, and doctors are able to provide more tailored care. This book delivers hopeful, helpful, and extensive information to all parties concerned: patients, caregivers, and doctors. The ultimate guide to symptoms and treatment, this thoroughly updated second edition is the first place patients should turn for reliable, easy-to-grasp information on Parkinson's Disease.
Author: J. Eric Ahlskog, PhD, MD Publisher: Oxford University Press ISBN: 0190231882 Category : Health & Fitness Languages : en Pages : 545
Book Description
The fundamental guide to the most effective treatments for Parkinson's Disease, from a Mayo Clinic doctor with thirty years of clinical and research experience. In this second edition follow-up to the extremely successful first edition, Dr. Ahlskog draws on thirty years of clinical experience to present the definitive guide to dealing with all aspects of Parkinson's Disease, from treatment options and side effects to the impact of the disease on caregivers and family. Dr. Ahlskog's goal is to educate patients so that they can better team up with their doctors to do battle with the disease, streamlining the decision-making process and enhancing their treatment. To do this, Dr. Ahlskog offers a gold mine of information, distilled from his years of experience treating people with Parkinson's at the Mayo Clinic. In addition to providing a comprehensive account of Parkinson's medications, this book also examines additional aspects of treatment, such as the role of nutrition, exercise, and physical therapy. Although many commendable texts have been written on the subject of Parkinson's Disease, their discussions of treatment have not been in depth. Dr. Ahlskog sifts through aspects of the disease in order to give the reader a comprehensive sense of Parkinson's and the best available treatment options. With a broader understanding of the disease and the available options, patients are able to make more informed choices, and doctors are able to provide more tailored care. This book delivers hopeful, helpful, and extensive information to all parties concerned: patients, caregivers, and doctors. The ultimate guide to symptoms and treatment, this thoroughly updated second edition is the first place patients should turn for reliable, easy-to-grasp information on Parkinson's Disease.
Author: Maria Nord Publisher: Linköping University Electronic Press ISBN: 9176855570 Category : Languages : sv Pages : 81
Book Description
Parkinson’s disease (PD) is one of the most common neurodegenerative disorders and it is caused by a loss of dopamine (DA) producing neurons in the basal ganglia in the brain. The PD patient suffers from motor symptoms such as tremor, bradykinesia and rigidity and treatment with levodopa (LD), the precursor of DA, has positive effects on these symptoms. Several factors affect the availability of orally given LD. Gastric emptying (GE) is one factor and it has been shown to be delayed in PD patients resulting in impaired levodopa uptake. Different enzymes metabolize LD on its way from the gut to the brain resulting in less LD available in the brain and more side effects from the metabolites. By adding dopa decarboxylase inhibitors (carbidopa or benserazide) or COMT-inhibitors (e.g. entacapone) the bioavailability of LD increases significantly and more LD can pass the blood-brain-barrier and be converted to DA in the brain. It has been considered of importance to avoid high levodopa peaks in the brain because this seems to induce changes in postsynaptic dopaminergic neurons causing disabling motor complications in PD patients. More continuously given LD, e.g. duodenal or intravenous (IV) infusions, has been shown to improve these motor complications. Deep brain stimulation of the subthalamic nucleus (STN DBS) has also been proven to improve motor complications and to make it possible to reduce the LD dosage in PD patients. In this doctoral thesis the main purpose is to study the pharmacokinetics of LD in patients with PD and motor complications; in blood and subcutaneous tissue and study the effect of GE and PD stage on LD uptake and the effect of continuously given LD (CDS) on LD uptake and GE; in blood and cerebrospinal fluid (CSF) when adding the peripheral enzyme inhibitors entacapone and carbidopa to LD infusion IV; in brain during STN DBSand during oral or IV LD treatment. To conclude, LD uptake is more favorable in PD patients with less severe disease and GE is delayed in PD patients. No obvious relation between LD uptake and GE or between GE and PD stage is seen and CDS decreases the LD levels. Entacapone increases the maximal concentration of LD in blood and CSF. This is more evident with additional carbidopa and important to consider in avoiding high LD peaks in brain during PD treatment. LD in brain increases during both oral and IV LD treatment and the DA levels follows LD well indicating that PD patients still have capacity to metabolize LD to DA despite probable pronounced nigral degeneration. STN DBS seems to increase putaminal DA levels and together with IV LD treatment also increases LD in brain possibly explaining why it is possible to decrease LD medication after STN DBS surgery. Parkinsons sjukdom (PS) är en av de vanligaste s.k. neurodegenerativasjukdomarna och orsakas av förlust av dopamin(DA)producerande nervceller i hjärnan. Detta orsakar motoriska symptom såsom skakningar, stelhet och förlångsammade rörelser. Levodopa (LD) är ett ämne, som kan omvandlas till DA i hjärnan och ge symptomlindring och det är oftast förstahandsval vid behandling av patienter med PS. Flera faktorer påverkar tillgängligheten av LD, bl.a. den hastighet som magsäcken tömmer sig med och denna verkar förlångsammad hos personer med PS vilket ger sämre tillgänglighet av LD i blodet och därmed i hjärnan. LD bryts även ner i hög grad av olika enzym ute i kroppen vilket leder till mindre mängd LD som hamnar i hjärnan och till fler nedbrytningsprodukter som orsakar biverkningar. Tillägg av enzymhämmare leder till ökad mängd LD som kan nå hjärnan och omvandlas till DA. Det anses viktigt att undvika höga toppar av LD i hjärnan då dessa verkar bidra till utvecklandet av besvärliga motoriska komplikationer hos patienter med PS. Om LD ges mer kontinuerligt, exempelvis som en kontinuerlig infusion in i tarmen eller i blodet, så minskar dessa motoriska komplikationer. Inopererande av stimulatorer i vissa delar av hjärnan (DBS) har också visat sig minska dessa motoriska komplikationer och även resultera i att man kan minska LD-dosen. Huvudsyftet med den här avhandlingen är att studera LD hos patienter med PS; i blod och fettvävnad då LD ges i tablettform och se om det finns något samband med LD-upptag och hastigheten på magsäckstömningen (MT) och om kontinuerligt given LD påverkar LD-upptaget eller MT; i blod och i ryggmärgsvätska då enzymhämmarna entakapon och karbidopa tillsätts LD; i hjärna vid behandling med DBS och då LD ges både som tablett och som infusion i blodet. Sammanfattningsvis kan vi se att LD-upptaget är mer gynnsamt hos patienter med PS i tidigare skede av sjukdomens komplikationsfas. MT är förlångsammad hos patienter med PS och det är inget tydligt samband mellan LD-upptag och MT eller mellan MT och sjukdomsgrad. Kontinuerligt given LD minskar LDnivåerna. Enzymhämmaren entakapon ökar den maximala koncentrationen av LD i blod och ryggmärgsvätska och effekten är mer tydlig vid tillägg av karbidopa vilket är viktigt att ta i beaktande vid behandling av PS för att undvika höga toppar av LD i hjärnan. LD ökar i hjärnan då man behandlar med LD i tablettform och som infusion i blodet och DA-nivåerna i hjärnan följer LD väl vilket visar på att patienter med PS fortfarande kan omvandla LD till DA trots trolig uttalad brist av de DA-producerande nervcellerna i hjärnan. DBS verkar öka DA i vissa områden i hjärnan och tillsammans med LD-infusion i blodet verkar det även öka LD i hjärnan och det kan förklara varför man kan sänka LDdosen efter DBS-operation.
Author: Cindy Levine Publisher: Department of Health and Human Services Pu Ncy for Healthcare Res ISBN: 9781587630880 Category : Evidence-based medicine Languages : en Pages : 306
Author: Rajesh Pahwa Publisher: CRC Press ISBN: 1841849081 Category : Medical Languages : en Pages : 622
Book Description
Highly Commended, BMA Medical Book Awards 2014 This volume has long prevailed as one of the leading resources on Parkinson's disease (PD). Fully updated with practical and engaging chapters on pathology, neurochemistry, etiology, and breakthrough research, this source spans every essential topic related to the identification, assessment, and treatment of PD. Reflecting the many advances that have taken place in the management of PD, this volume promotes a multidisciplinary approach to care and supplies new sections on the latest pharmacologic, surgical, and rehabilitative therapies, as well as essential diagnostic, imaging, and nonmotor management strategies. New to this edition: • Early identification of premotor symptoms • Potential disease modification agents • Physical and occupational therapy
Author: National Collaborating Centre for Chronic Conditions (Great Britain) Publisher: Royal College of Physicians ISBN: 1860162835 Category : Basal ganglia Languages : en Pages : 243
Author: Robert R. Goodman Publisher: Springer ISBN: 9783319236926 Category : Medical Languages : en Pages : 0
Book Description
Deep brain stimulation for the treatment of patients with Parkinson’s disease was introduced in the 1990s. Initially performed only at academic centers, over the past decade it has become a widespread surgical procedure. A variety of surgical techniques are employed and innovations are introduced frequently. This book is an ideal source of information for the many practicing neurosurgeons who did not learn this surgery during their training but would now like to add it to their practice, as well as an excellent update on exciting new developments in surgery for Parkinson’s disease. This book is designed to provide practicing neurosurgeons with current knowledge on the practical aspects of surgical treatment of patients with Parkinson’s disease. It explains how to identify surgical candidates and determine the optimal surgery, describes the various surgical techniques that are currently employed, and offers insights into how to optimize deep brain stimulation therapy after implantation. The keys to avoidance of surgical complications are carefully elucidated. In addition, an overview is provided of potential advances on the near-term horizon, including closed-loop deep brain stimulation, gene therapy, and optogenetics. All topics are covered by experienced Parkinson’s disease surgeons, in a concise and digestable format. The book will be an ideal source of information for the many practicing neurosurgeons who would like to add deep brain stimulation to their practice, as well as an excellent update on new developments in surgery for Parkinson’s disease.
Author: Jonas H. Ellenberg Publisher: CRC Press ISBN: 9780824788230 Category : Medical Languages : en Pages : 600
Book Description
This comprehensive reference provides a detailed overview of current concepts regarding the cause of Parkinson's disease-emphasizing the issues involved in the design, implementation, and analysis of epidemiological studies of parkinsonism.
Author: K. Ray Chaudhuri Publisher: Oxford University Press, USA ISBN: 0199684243 Category : Medical Languages : en Pages : 517
Book Description
Patients with Parkinson's disease (PD) are known to suffer from motor symptoms of the disease, but they also experience non-motor symptoms (NMS) that are often present before diagnosis or that inevitably emerge with disease progression. The motor symptoms of Parkinson's disease have been extensively researched, and effective clinical tools for their assessment and treatment have been developed and are readily available. In contrast, researchers have only recently begun to focus on the NMS of Parkinson's Disease, which are poorly recognized and inadequately treated by clinicians. The NMS of PD have a significant impact on patient quality of life and mortality and include neuropsychiatric, sleep-related, autonomic, gastrointestinal, and sensory symptoms. While some NMS can be improved with currently available treatments, others may be more refractory and will require research into novel (non-dopaminergic) drug therapies for the future. Edited by members of the UK Parkinson's Disease Non-Motor Group (PD-NMG) and with contributions from international experts, this new edition summarizes the current understanding of NMS symptoms in Parkinson's disease and points the way towards future research.
Author: Marilyn Trail Publisher: SLACK Incorporated ISBN: 9781556427718 Category : Medical Languages : en Pages : 384
Book Description
'Neurorehabilitation in Parkinson's Disease' serves as a reference for the treatment of patients with Parkinson's disease. In addition to providing treatment models for physical therapy, occupational therapy, & speech-language pathology, the text covers topics such as review of pathophysiology, & symptomatology.
Author: J. Eric Ahlskog, PhD, MD
Author: J. Eric Ahlskog, PhD, MD
Author: Maria Nord
Author: Cindy Levine
Author: Rajesh Pahwa
Author: National Collaborating Centre for Chronic Conditions (Great Britain)
Author: Robert R. Goodman
Author: Michael S. Okun
Author: Jonas H. Ellenberg
Author: K. Ray Chaudhuri
Author: Marilyn Trail