Psychiatric and Cognitive Disorders in Parkinson's Disease by Sergio E. Starkstein PDF

By Sergio E. Starkstein

This ebook presents a entire account of the emotional and cognitive features of Parkinson's sickness, derived from the neurological and psychiatric evaluate of hundreds and hundreds of sufferers via the authors. It bargains an intensive survey of the printed literature at the subject and readers will discover a whole and invaluable assessment of the scientific gains and remedy of Parkinson's ailment, by way of discussions of linked depressive problems, anxiousness, phobias, apathy, hallucinations, delusions, and sleep issues. The authors additionally speak about particular cognitive deficits and the mechanisms for those problems, in addition to the psychiatric and cognitive negative effects of anti-parkinsonian drugs and new surgical remedies.

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An important Wnding of that study was that depressed patients with full remission of depression at follow-up showed a signiWcant decrease in UPDRS (UniWed Parkinson’s Disease Rating Scale) scores, suggesting that parkinsonism in depression may be reversible upon the improvement of the mood disorder. On the other hand, depressed patients without remission of depression showed no improvement of parkinsonian signs and further cognitive decline, suggesting an underlying dementia disorder. Vascular parkinsonism Clinical vignette A 68-year-old man with a history of heavy smoking, hypertension, and hypercholesterolemia had an ischemic heart attack treated with angioplasty 10 years before the evaluation.

Moreover, both treatments produced a similar rate of side-eVects, which were mostly transient. , 1998). , 2000). However, Miyawaki et al. (2000) reported a patient who suVered transient episodes of mania and hypomania occurring after left, right or bilateral GPi stimulation. , 2000). Other nonfrequent complications of this procedure include deep-brain hematomas and postoperative seizures. Stimulation may produce slight and transient paresthesias, dystonia contralateral to the electrode placement, postural imbalance, and dysarthria.

Features supportive of the diagnosis are: • Repeated falls • Syncope • Transient loss of consciousness • Neuroleptic sensitivity • Systematized delusions • Hallucinations in other modalities 4. , positive neurologic signs, or vascular lesions on brain imaging) • Evidence on physical examination or laboratory investigation of any physical illness or other brain disorder that suYciently accounts for the clinical picture Adapted from McKeith et al. (2000). drowsiness, or transient confusion. , 2000).

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