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Chapter-13 Treatment of Nonmotor Symptoms of Parkinson’s Disease and Other Disorders

BOOK TITLE: Understanding Parkinsonism: The Clinical Perspective

Author
1. Erro Roberto
ISBN
9789386322333
DOI
10.5005/jp/books/14125_14
Edition
1/e
Publishing Year
2018
Pages
10
Author Affiliations
1. University of Salerno, Salerno, Italy
Chapter keywords
Nonmotor symptom, NMS, Parkinson’s disease, randomized controlled trial, RCT, dopaminergic therapy, gastrointestinal symptom, genitourinary symptom, cardiovascular symptom, cognitive impairment

Abstract

This chapter focuses on treatment of nonmotor symptoms of Parkinson’s disease and other disorders. It is well known that patients with Parkinson’s disease manifest with a number of nonmotor symptoms (NMS) that can arise at any stages of the disease, even before overt motor disturbances become evident. Nonmotor symptoms will be categorized in three main domains—autonomic symptoms (including gastrointestinal, genitourinary, and cardiovascular symptoms), neuropsychiatric symptoms, and sleep symptoms with a further section dedicated to pain and fatigue. This chapter covers the autonomic symptoms, sleep domain, neuropsychiatric domain, impulsive compulsive behaviors, and other nonmotor symptoms such as pain and fatigue. Sleep symptoms include excessive daytime sleepiness (EDS), vivid dreams, and REM (rapid eye movement) sleep behavior disorder (RBD) and affect more than two-thirds of patients. Cognitive dysfunction is frequent in Parkinson’s disease and it can occur from the early stages. It has a negative impact on the daily lives of patients and their caregivers and may be associated with subtle functional impairments. Patients with cognitive impairment often manifest with other NMS including hallucinations, sleep and mood disturbances.

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