Neurol. pro Praxi, 2001; 1: 25-30

Terapie idiopatické parkinsonovy nemoci

MUDr. Irena Rektorová, Ph.D.
Centrum pro abnormální pohyby a parkinsonismus, I. neurologická klinika LF MU, FN u sv. Anny, Brno

Keywords: Parkinsonova nemoc, terapie, fluktuace, dyskinézy, dopaminomimetická psychotická porucha.

Published: December 31, 2001  Show citation

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Rektorová I. Terapie idiopatické parkinsonovy nemoci. Neurol. praxi. 2001;2(1):25-30.

Zlatým standardem léčby Parkinsonovy nemoci (PN) zůstává přes nové pokroky ve farmakoterapii a přes nové chirurgické možnosti stále L-dopa. Po 3-5 letech jejího výborného efektu v léčbě hybných symptomů PN se začnou u poloviny pacientů objevovat pozdní hybné a psychiatrické komplikace, mezi které patří především fluktuace, dyskinézy, halucinace a bludy. Jejich etiopatogeneze není zatím přesně známa, pravděpodobně k nim dochází jednak v důsledku progrese onemocnění, jednak v důsledku dlouhodobé pulzní terapie exogenně dodávané L-dopy. V textu popisuji různé strategie léčby a jednotlivé léky, které umožňují tyto pozdní symptomy oddálit nebo zmírnit. Přesto by terapie nikdy neměla být schématická, ale zcela individuální. Nedílnou součástí léčby PN je rehabilitace, léčba deprese, anxiety, poruch spánku, vegetativních symptomů, možného kognitivního deficitu aj. příznaků, které ovšem přesahují rámec tohoto sdělení.

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