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Treatment of Parkinson's disease in Thailand: review of the literature and practical recommendations.
J Med Assoc Thai. 2009 Jan; 92(1):142-54.JM

Abstract

The mainstay of treatment for Parkinson's Disease (PD) remains symptomatic despite the rapid expansion in knowledge of its neurodegenerative process. Therapeutic options, both medical and surgical, have been markedly improved over the past decades, resulting in better motor function, activities of daily living, and quality of life for PD patients. The principle of PD management should be individualized and the selection of treatments should aim to control symptoms as well as to prevent or delay motor complications. In Thailand, various pharmacologic and surgical options are available, including different formulations of levodopa, dopamine agonists, monoamine oxidase B inhibitor, cathechol-O-methyltransferase inhibitor pallidotomy, and lastly deep brain stimulation. The use of dopamine agonists in early PD has a levodopa-sparing effect and reduces the incidence of motor complications. Continuous dopaminergic stimulation (CDS), which mimics physiological activation of dopaminergic receptors, has been proposed as a strategy to prevent motor complications. Based on current evidence, practical guidelines in the medical management of different types of motor complications are outlined in the present article according to what are available in Thailand. Surgical interventions should be reserved for patients with intractable motor complications after careful patient selection.

Authors+Show Affiliations

Chulalongkorn Comprehensive Movement Disorders Center, Chulalongkorn University Hospital, Bangkok, Thailand. rbhl@ucla.eduNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

19260256

Citation

Bhidayasiri, Roongroj, and Helen Ling. "Treatment of Parkinson's Disease in Thailand: Review of the Literature and Practical Recommendations." Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, vol. 92, no. 1, 2009, pp. 142-54.
Bhidayasiri R, Ling H. Treatment of Parkinson's disease in Thailand: review of the literature and practical recommendations. J Med Assoc Thai. 2009;92(1):142-54.
Bhidayasiri, R., & Ling, H. (2009). Treatment of Parkinson's disease in Thailand: review of the literature and practical recommendations. Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, 92(1), 142-54.
Bhidayasiri R, Ling H. Treatment of Parkinson's Disease in Thailand: Review of the Literature and Practical Recommendations. J Med Assoc Thai. 2009;92(1):142-54. PubMed PMID: 19260256.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of Parkinson's disease in Thailand: review of the literature and practical recommendations. AU - Bhidayasiri,Roongroj, AU - Ling,Helen, PY - 2009/3/6/entrez PY - 2009/3/6/pubmed PY - 2009/4/1/medline SP - 142 EP - 54 JF - Journal of the Medical Association of Thailand = Chotmaihet thangphaet JO - J Med Assoc Thai VL - 92 IS - 1 N2 - The mainstay of treatment for Parkinson's Disease (PD) remains symptomatic despite the rapid expansion in knowledge of its neurodegenerative process. Therapeutic options, both medical and surgical, have been markedly improved over the past decades, resulting in better motor function, activities of daily living, and quality of life for PD patients. The principle of PD management should be individualized and the selection of treatments should aim to control symptoms as well as to prevent or delay motor complications. In Thailand, various pharmacologic and surgical options are available, including different formulations of levodopa, dopamine agonists, monoamine oxidase B inhibitor, cathechol-O-methyltransferase inhibitor pallidotomy, and lastly deep brain stimulation. The use of dopamine agonists in early PD has a levodopa-sparing effect and reduces the incidence of motor complications. Continuous dopaminergic stimulation (CDS), which mimics physiological activation of dopaminergic receptors, has been proposed as a strategy to prevent motor complications. Based on current evidence, practical guidelines in the medical management of different types of motor complications are outlined in the present article according to what are available in Thailand. Surgical interventions should be reserved for patients with intractable motor complications after careful patient selection. SN - 0125-2208 UR - https://www.unboundmedicine.com/medline/citation/19260256/Treatment_of_Parkinson's_disease_in_Thailand:_review_of_the_literature_and_practical_recommendations_ DB - PRIME DP - Unbound Medicine ER -