PARKINSONS-DISEASE

Parkinson's disease is a common disabling disease of old age. The diag nosis of idiopathic Parkinson's disease is based on clinical signs and has poor sensitivity, with about 25% of patients confidently diagnose d as having the disease actually having other conditions such as multi -system atrophy and other parkinsonism-plus syndromes. Benign essentia l tremor and arteriosclerotic pseudoparkinsonism can easily be confuse d with Parkinson's disease. The cause of Parkinson's disease remains u nknown. Speculative research highlights the role of oxidative stress a nd free radical mediated damage to dopaminergic cells. Parkinson's dis ease is the one neurodegenerative disorder in which drugs have been de monstrated to be of value. There is now a wide variety of drugs and fo rmulations available, including anticholinergics, amantidine, L-dopa, dopamine agonists including apomorphine, selegiline and soon to be ava ilable catechol-O-methyltransferase inhibitors. Disabling side-effects of treatment, fluctuations, dyskinesias and psychiatric problems requ ire strategic use of the drugs available. There is an increasing poten tial for neurosurgical intervention.