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New and emerging treatments for Parkinson disease

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The main aim is to maintain quality of life throughout the illness

World Parkinson’s Day commemorates the birth of James Parkinson on 11 April 1755, and it will soon be the 200th anniversary of his description of the “shaking palsy”.1 In this article I highlight some of the advances in Parkinson disease (PD) therapy since the topic was most recently reviewed in the Journal.2

The first step: diagnosis

The diagnosis of PD is the first step in its management. Even years after PD is diagnosed, patients report that “satisfaction with the explanation of the condition at diagnosis” continues to have an impact on quality of life.3 Diagnosis is not always straightforward. In a UK study, only 44% of patients with PD were initially referred to a neurologist, the other patients being referred to general physicians, orthopaedic surgeons, urologists, psychiatrists and rheumatologists. Pain was the symptom that most frequently impaired the recognition of PD, while frozen shoulder, spondylosis, depression and anxiety were among the common misdiagnoses.4 The 1997 charter of the European Parkinson’s Disease Association recommends that all patients be referred to a doctor with a special interest in PD.5

Managing non-motor symptoms