Invasive Methods in the Treatment of Advanced Parkinson’s Disease

Authors: K. Gmitterová 1;  M. Minár 1;  Z. Košutzká 1;  P. Valkovič 1,2
Authors‘ workplace: II. Neurologická klinika LF UK a UN Bratislava 1;  Inštitút normálnej a patologickej fyziológie, Slovenská akadémia vied, Bratislava 2
Published in: Cesk Slov Neurol N 2017; 80/113(5): 503-516
Category: Minimonography


Advanced stages of Parkinson‘s disease are accompanied by a broad scale of motor and non-motor complications which negatively impact patients’ quality of life. The therapeutic influence of these complications resulting from the neurodegenerative nature of the underlying disease and are additionally caused by long-term use of dopaminergic treatment, represents a serious clinical problem. Recently, the therapeutic strategy has been focused on continuous dopaminergic stimulation to achieve the balanced control of symptoms. With disease progression and drug-induced complications conventional pharmacological procedures often fail to control clinical symptoms. Alternative methods rise to the forefront of therapeutic interest as they play an important role in the treatment of advanced Parkinson‘s disease. These options include: deep brain stimulation, subcutaneous application of apomorphine and levodopa/carbidopa intestinal gel therapy. Correct patient selection, consideration of specific non-motor symptoms and potential risks accompanying individual treatment modalities, significantly contribute to the selection of most appropriate procedure.

Key words:
Parkinson’s disease – motor complications of advanced Parkinson’s disease – non-motor complications – continuous dopaminergic stimulation – levodopa/carbidopa intestinal gel – apomorphine – deep brain stimulation – DBS

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.


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