Treatment of Motor Symptoms of Parkinson Disease - Flowchart
Treatment of Motor Symptoms of Parkinson Disease - Flowchart Parkinson Disease Parkinson Disease
«Flowchart»

Treatment of motor symptoms of Parkinson disease

Treatment of motor symptoms of Parkinson disease

Treatment of motor symptoms of Parkinson disease

Treatment of motor symptoms of Parkinson disease

DAT or VMAT imaging

DAT or VMAT imaging

DAT or VMAT imaging

Diagnosis of PD

Diagnosis of PD

Diagnosis of PD

Diagnosis of PD

Established

Established

Established

Uncertain

Uncertain

Uncertain

Consider alternative Dx and Rx

Consider alternative Dx and Rx

Consider alternative Dx and Rx

End

End

End

Exercise ± MAOB-I (selegiline, rasagiline)

Exercise ± MAOB-I (selegiline, rasagiline)

Exercise ± MAOB-I (selegiline, rasagiline)

Functional impairment?

Functional impairment?

Functional impairment?

Minimal or none

Minimal or none

Minimal or none

Yes

Yes

Yes

Initiate DA therapy (pramipexole, ropinirole, rotigotine)

Initiate DA therapy (pramipexole, ropinirole, rotigotine)

Initiate DA therapy (pramipexole, ropinirole, rotigotine)

Disease progression

Disease progression

Disease progression

Add or increase levodopa

Add or increase levodopa

Add or increase levodopa

Motor complications

Motor complications

Motor complications

Dose adjustments, continuous levodopa or DA delivery

Dose adjustments, continuous levodopa or DA delivery

Dose adjustments, continuous levodopa or DA delivery

Experimental therapeutics

Experimental therapeutics

Experimental therapeutics

DBS or FUS

DBS or FUS

DBS or FUS

Entacapone, opicapone, amantadine, safinamide, istradefylline, apomorphine, inhalable levodopa

Entacapone, opicapone, amantadine, safinamide, istradefylline, apomorphine, inhalable levodopa

Entacapone, opicapone, amantadine, safinamide, istradefylline, apomorphine, inhalable levodopa

Dose adjustments, continuous levodopa or DA delivery

Dose adjustments, continuous levodopa or DA delivery

Dose adjustments, continuous levodopa or DA delivery

Motor complications

Motor complications

Motor complications

Entacapone, opicapone, amantadine, safinamide, istradefylline, apomorphine, inhalable levodopa

Entacapone, opicapone, amantadine, safinamide, istradefylline, apomorphine, inhalable levodopa

Entacapone, opicapone, amantadine, safinamide, istradefylline, apomorphine, inhalable levodopa

Anticholinergics, BoNT for tremor

Anticholinergics, BoNT for tremor

Anticholinergics, BoNT for tremor

Initiate levodopa

Initiate levodopa

Initiate levodopa

Mild sxs or young

Mild sxs or young

Mild sxs or young

Troublesome sxs or elderly

Troublesome sxs or elderly

Troublesome sxs or elderly