Introduction to the evaluation of Parkinson’s disease
Parkinson’s disease (PD) is a progressive neurodegenerative disease affecting about 1% of the United States population over the age of 65 years. The cardinal motor symptoms of PD include tremor, bradykinesia, rigidity, and postural instability. Dopaminergic replacement with carbidopa or levodopa along with adjunctive medications is the mainstay treatment for motor signs and symptoms of PD. Over time, patients with PD will develop motor fluctuations and dyskinesia. Tremor, bradykinesia, postural instability, motor fluctuation, and dyskinesia can all impair quality of life in patients with PD. PD motor symptoms, including dyskinesia, can vary from minute to minute and patients may have difficulty explaining to their physicians what symptoms they have and at what time of day they have them.