Parkinson's Disease: Diagnosis and Clinical Management

History. James Parkinson: The man and the Essay Paralysis Agitans in the 19th Century Charcot and Parkinson's disease Parkinson's Disease in the 20th century: A time line of important events. Clinical Aspects: Epidemiology Cardinal features of early disease The gait disturbances in PD Sensory symptoms Speech, Voice and Swallowing Disorders Gastrointestinal features Autonomic Nervous System dysfunction Sleep Disorders Natural History Quantitative measures / Rating scales. Behavioral and Psychiatric Manifestations: Dementia Dementia with Lewy bodies and Alzheimer's disease and their relationship to PD Depression Anxiety and Panic disorder Apathy and the motivational state. Pathology and Neurochemistry: Pathology Neurochemistry Basal Ganglia Anatomy & Physiology Dopamine receptor Diversity. Diagnosis: Problems in Diagnosis Positron emission tomography Single photon emission tomography and Dopamine transporter imaging. Etiology and Pathogenesis: Etiology: The roles of environment and genetics Pathogenesis: Oxidative stress, mitochondrial dysfunction and excitotoxicity Apoptosis The impact of MPTP on Parkinson's Disease research: past, present and future Cerebrospinal Fluid neurotoxicity: clues to pathogenesis. Drugs: Levodopa: 30 years of progress Amantadine and Anticholinergics Monoamine oxidase inhibitors Dopamine Agonists COMT inhibitors Atypical Antipsychotics Excitatory Amino Acid receptor antagonists Other therapies. Treatment Issues: Motor Fluctuations and Dyskinesia Fluctuations of non-motor symptoms Psychosis Status on Protective therapies Treatment approaches for Early Disease Progress in Gene therapy Neurotrophic Factors Smoking and Nicotine. Surgery: Stereotactic Pallidotomy & Thalamotomy Thalamic Stimulation Pallidal and Subthalamic stimulation Neural transplantation. Subtypes of Parkinsonism: Juvenile and Young onset Parkinsonism Is there a Familial form? The Parkinson-Plus Syndromes Symptomatic Parkinsonism. Social Issues: Quality of Life Issues Family Caregiving Economic impact: Implications for Interventions Driving.