Parkinson Disease: Kanovsky P

Horstink M, Tolosa E, Bonuccelli U, Deuschl G, Friedman A, Kanovsky P, Larsen JP, Lees A, Oertel W, Poewe W, Rascol O, Sampaio C, Anonymous00036, Anonymous00037. · Department of Neurology, Radboud University Medical Centre, Nijmegen, The Netherlands. · Eur J Neurol. · Pubmed #17038032 No free full text.

Abstract: To provide evidence-based recommendations for the management of late (complicated) Parkinson's disease (PD), based on a review of the literature. Complicated PD refers to patients suffering from the classical motor syndrome of PD along with other motor or non-motor complications, either disease-related (e.g. freezing) or treatment-related (e.g. dyskinesias or hallucinations). MEDLINE, Cochrane Library and INAHTA database literature searches were conducted. National guidelines were requested from all EFNS societies. Non-European guidelines were searched for using MEDLINE. Part II of the guidelines deals with treatment of motor and neuropsychiatric complications and autonomic disturbances. For each topic, a list of therapeutic interventions is provided, including classification of evidence. Following this, recommendations for management are given, alongside ratings of efficacy. Classifications of evidence and ratings of efficacy are made according to EFNS guidance. In cases where there is insufficient scientific evidence, a consensus statement ('good practice point') is made.

Horstink M, Tolosa E, Bonuccelli U, Deuschl G, Friedman A, Kanovsky P, Larsen JP, Lees A, Oertel W, Poewe W, Rascol O, Sampaio C, Anonymous00034, Anonymous00035. · Department of Neurology, Radboud University Medical Centre, Nijmegen, The Netherlands. · Eur J Neurol. · Pubmed #17038031 No free full text.

Abstract: The aim of the study was to provide evidence-based recommendations for the management of early (uncomplicated) Parkinson's disease (PD), based on a review of the literature. Uncomplicated PD refers to patients suffering from the classical motor syndrome of PD only, without treatment-induced motor complications and without neuropsychiatric or autonomic problems. MEDLINE, Cochrane Library and International Network of Agencies for Health Technology Assessment (INAHTA) database literature searches were conducted. National guidelines were requested from all European Federation of Neurological Societies (EFNS) societies. Non-European guidelines were searched for using MEDLINE. Part I of the guidelines deals with prevention of disease progression, symptomatic treatment of motor features (parkinsonism), and prevention of motor and neuropsychiatric complications of therapy. For each topic, a list of therapeutic interventions is provided, including classification of evidence. Following this, recommendations for management are given, alongside ratings of efficacy. Classifications of evidence and ratings of efficacy are made according to EFNS guidance. In cases where there is insufficient scientific evidence, a consensus statement (good practice point) is made.

Bartova P, Skoloudik D, Bar M, Ressner P, Hlustik P, Herzig R, Kanovsky P. · Department of Neurology, University Hospital, Ostrava, Czech Republic. · Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. · Pubmed #19219216 links to  free full text

Abstract: BACKGROUND: Transcranial sonography (TCS) in the B-mode has the ability to image, infratentorial and supratentorial brain structures. For this reason, it has potential use in the diagnosis and differential diagnosis of various intracranial pathologies. METHODS AND RESULTS: The authors reviewed the contribution of TCS to the differentiation of a number of neurodegenerative diseases: in parkinsonian syndromes, TCS can evaluate echogenicity changes in specific structures such as the hyperechogenic area of the substantia nigra (SN) in Parkinson's disease and the hyperechogenic caudate nucleus in Huntington's disease as well as the hyperechogenic lentiform nucleus (LN) in dystonia and Wilson's disease. In parkinson-plus syndromes, TCS may detect changes in width of the third ventricle and of the frontal horns of the lateral ventricle. The hyperechogenic SN can also be used in healthy populations as a marker of subclinical injury to the nigrostriatal system. CONCLUSION: TCS is a quick, safe and non-invasive method. It could be helpful in differentiation between several movement disorders together with clinical examination and other neuroimaging methods.

Chovancova Z, Kanovsky P, Dufek J, Nevrly M, Otruba P. · Department of Neurology, Faculty of Medicine and Dentistry, Palacky University Olomouc, and University Hospital Olomouc Center for the Diagnosis and Treatment of Neurodegenerative Diseases, Czech Republic. · Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. · Pubmed #19365528 links to  free full text

Abstract: BACKGROUND: The aim of this study was to test the hypothesis that there is concomitant peripheral nerve involvement in patients suffering from neurodegenerative disorders by correlating motor and peripheral nerve involvement in Parkinson's disease. METHODS AND RESULTS: A total of 23 patients suffering from Parkinson's disease diagnosed strictly according to the UKPDBB criteria were examined. The group comprised 14 males (mean age: 57 years, mean age at onset: 51 years, mean duration of disease: 7 years, mean duration of dopaminergic treatment: 4 years) and 9 females (mean age: 67 years, mean age at onset: 63 years, mean duration of disease: 4 years, mean duration of dopaminergic treatment: 1 year). CONCLUSION: Polyneuropathy was clinically present and confirmed using EMG examination in 10 patients (43.5 %), 5 males and 5 females. This suggests that the neurodegenerative process involves both the central and the peripheral nervous system in Parkinson's patients.