Current concepts in the diagnosis and management of Parkinson's disease

CMAJ. 2003 Feb 4;168(3):293-301.


Parkinson's disease is a progressive neurological disorder characterized by rest tremor, bradykinesia, rigidity and postural instability. The cause is unknown, but growing evidence suggests that it may be due to a combination of environmental and genetic factors. Treatment during the early stage of Parkinson's disease has evolved, and evidence suggests that dopamine agonist monotherapy may prevent the response fluctuations that are associated with disease progression. L-dopa therapy, however, remains the most efficacious treatment. Treatment during the advanced stage focuses on improving control of a number of specific clinical problems. Successful management of motor response fluctuations (e.g., "wearing off," on-off fluctuations, nighttime deterioration, early morning deterioration and dyskinesias) and of psychiatric problems is often possible with specific treatment strategies. Surgical treatment is an option for a defined patient population.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Age Distribution
  • Antiparkinson Agents / administration & dosage*
  • Canada / epidemiology
  • Disease Progression
  • Female
  • Humans
  • Male
  • Parkinson Disease / diagnosis*
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / epidemiology
  • Quality of Life*
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Sex Distribution
  • Survival Rate


  • Antiparkinson Agents