Advanced Parkinson Disease by Dr Damith Liyanage
Channel: ASN Neurology
Date: 2021-07-09

Webinar 21 - 10 Pearls Series

Webinar series conducted by the Association of Sri Lankan Neurologists targeted at the Medical Officers, Medical Registrars, General Physicians, Family Physicians and Medical Students. A journey of 32 neurology topics, each with 10 pearls.

The twenty-first lecture in the series, Early Parkinson Disease is delivered by Dr Damith Liyanage. He is a Consultant Neurologist currently attached to the Karapitiya Teaching Hospital of Sri Lanka.

10 Pearls of this lecture
1. Even though there are no consensus about the transition point from early to advanced Parkinson Disease, specific features exist which might be sufficient enough to classify as Advanced Parkinson Disease
2. With time patients experience a range of fluctuations and reduced responsiveness to Levodopa which is termed wearing off/motor fluctuations.
3. Dyskinesia can develop at different times in relation to the antiparkinsonian effect of levodopa.
4. Falls, postural deformities, dysphagia, speech abnormalities and refractory tremor are common non Levodopa responsive motor features.
5. Levodopa and amantadine in pharmacological management.
6. DBS, LCIG, CSAI are used in Levodopa responsive patients with troublesome motor complications.
7. Neuropsychiatric, cognitive, dysautonomic, sleep and sensory related non motor features become more prominent as the disease advances.
8. Management of non motor features is important but challenging
9. Critical issues in advanced Parkinson Disease
10. caregiver burden needs to be addressed throughout and palliative care pathway needs to be considered in advanced stages.

Thumbnail artwork credits - Photo by Cristian Newman from Unsplash

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