Treatment strategies in advanced Parkinson's disease: Review of the literature

Parkinson hastalığı (PH), özellikle substansiya nigra pars kompakta bölgesindeki dopamine salgılayan hücreler olmak üzere bazal gangliayı etkileyen kronik, nörodejeneratif bir bozukluktur. Sıklıkla 50 yaş üzeri kişileri etkiler. Bununla birlikte daha genç başlangıç da bildirilmektedir. Bazal gangliada devam eden bir dopaminerjik hücre ölümü olduğundan, ileri dönemlerde ciddi özürlülüğe yol açabilen ilerleyici bir hastalıktır. PH' nın ileri dönemeleri, motor dalgalanmalar, yürüyüşte donmalar, diskinezi, postüral instabilite, düşmeler, otonomik tutulum, non-motor semptomlar nedeniyle hastalar için olduğu kadar klinisyenler için de zorlayıcıdır. Bu semptomatoloji, sıklıkla ileri evre PH olarak tanımlanan Hoehn and Yahr (H&Y) skalasında evre 4-5' e karşılık gelir. Bu derlemede ileri evre PH olan hastalarda tedavi seçenekleri tartışılmıştır.

İleri evre Parkinson hastalığında tedavi stratejileri: Literatürün gözden geçirilmesi

Parkinson's disease (PD) is a chronic, neurodegenerative disorder affecting basal ganglia, dopamine-secreting cells in the pars compacta region of the substantia nigra, in particular. It commonly affects people above the age of 50, however younger -onset has also been reported. Since there is an ongoing dopaminergic cell death in basal ganglia, it is a progressive disorder leading to severe disability in the late stages of the disease. The advanced stages of PD are the most challenging part of the disease for clinicians, as well as the patients' themselves due to the motor fluctuations, freezing of gait, dyskinesia, postural instability, falls, autonomic involvement, non-motor symptoms. This symptomatology corresponds to the stage of 4-5 on the Hoehn and Yahr (H&Y) scale, which is commonly defined as advanced PD. The treatment options in the patients with advanced PD are discussed in this review.

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