Treatment of late Parkinson’s disease with apomorphine pump and surgical methods
Keywords:
Apomorphine pump, deep brain stimulation, efficiency, late PDAbstract
Parkinson’s disease (PD) is a neurodegenerative disease with motor and non-motor symptoms. According to the stage of progression and the arising of motor complications, the disease could be divided into three stages: early PD, late PD and terminal phase. In the last two stages Apomorphine infusion and surgical methods of treatment could be applied. Apomorphine is available in two forms: a pen-like injection for a rescue therapy and a portable pump for a continuous infusion. Its good efficacy on morning dystonia, dysphagia and pain syndromes, reduced duration of “off” periods, and increasing of the “on” periods, has been proved by many clinical trials.
Palidotomy, thalamotomy and deep brain stimulation (DBS) are amongst surgical methods of treatment of PD. Nowadays DBS is the most common method, and the frequent targeting structures are nucleus subthalamicus and globus pallidus internus. DBS improves mostly tremor, rigidity, duration of “off” periods and existing dyskinesia. Both methods have proved their efficacy over the years and have good results on Parkinson’s symptoms. The selection of a suitable patient must be on the basis of a very precise evaluation and investigation, in a close collaboration among different specialists.
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Copyright (c) 2018 Elena Chorbadjieva, I. Milanov, D. Georgiev
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