This CPD E-Module, led by Professor C. E. Clarke, explores critical aspects of Parkinson's disease management and treatment efficacy through multiple-choice questions. It assesses understanding of therapeutic options, disease-modifying trials, and rehabilitation strategies, enhancing clinical decision-making skills.
Further trials of all rehabilitation therapies are required at all stages of the disease
There is firm evidence of the efficacy of physiotherapy and occupational therapy in the early stages of the disease
There is firm evidence of the efficacy of physiotherapy and occupational therapy in the later stages of the disease
There is firm evidence of the efficacy and cost effectiveness of Lee Silverman Voice Training in all stages of the disease
There is firm evidence of the efficacy of traditional NHS speech and language therapy in all stages of the disease.
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Creatine
Co-enzyme Q10
Isradipine
Cogane
Riluzole
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Adenosine antagonists
Dopamine antagonists
Dopamine re-uptake inhibitors
Partial dopamine agonists
Alpha-2 noradrenergic antagonists
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Inconsistent results with the 1 mg/d and 2 mg/d results in the two trials
Lack of clinical significance of the results
Absence of quality of life data
Absence of health economics analysis
All of the above
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Poor compliance
Nocturnal akinesia
Severe motor fluctuations
Early morning akinesia
All of the above
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ADAGIO
EASE- PD
STRIDE – PD
RECOVER
PROUD
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Entacapone
Rasagiline
Amantadine
Selegiline
Non-ergot dopamine agonist
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The evidence-base is poor and it is currently uncertain with what such a patient should be treated.
Non-ergot dopamine agonist
Levodopa
Monoamine oxidase B inhibitor
Amantadine
Subthalamic deep brain stimulation surgery is inappropriate because it may aggravate his depression and trigger suicidal ideation
Apomorphine is not appropriate as he is more likely to develop skin nodules
If given intestinal levodopa gel infusion, the neuropathy should be monitored in case it deteriorates due to interference with vitamin B12 metabolism
Intestinal levodopa gel infusion is inappropriate because he has not been considered for apomorphine or surgery as per the Summary of Product Characteristics
Whichever option is chosen, his mental state should be monitored carefully in view of the risk of Parkinson's disease dementia.
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Any trials comparing apomorphine infusion, deep brain stimulation surgery, and intestinal levodopa gel infusion in randomised controlled trials
Positive randomised controlled trials of apomorphine infusion versus best medical therapy
Positive randomised controlled trials of deep brain stimulation surgery and intestinal levodopa gel infusion versus best medical therapy
Positive effects of deep brain stimulation surgery on quality of life
None of the above
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