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Введение

Болезнь Паркинсона (БП) - это наиболее распространенное нейродегенеративное двигательное расстройство, которым страдают миллионы взрослых во всем мире. Прогрессирующая дегенерация дофамин-продуцирующих нейронов в черной субстанции среднего мозга, приводит к появлению как классической клинической триады (тремор, ригидность и брадикинезия), так и широкого спектра немоторных и нейропсихиатрических проявлений, влияющих на функциональное состояние и качество жизни. На сегодняшний день стало понятно, что БП — это не просто расстройство, связанное с истощением дофамина. Другие области мозга, как внутри, так и вне базальных ганглиев, также подвергаются потере клеток и биохимическим нарушениям.

Лечение БП требует тщательной оценки симптомов пациента, возраста, стадии заболевания, степени функциональных нарушений, а также уровня физической активности и трудоспособности. Для максимального сохранения моторных и немоторных функций, а также качества жизни на протяжении всего течения болезни применяется широкий спектр симптоматических фармакологических, нефармакологических и хирургических методов лечения.

Общие вопросы

Монотерапия леводопой (для большинства пациентов)

Другие схемы терапии (для отдельных групп пациентов)

Коррекция побочных эффектов дофаминэргической терапии

Другие вопросы ведения пациентов

Алгоритм начальной фармакотерапии пациентов с БП

Резюме

Список литературы