Parkinson’s Disease and Related Disorders

  • Janis M. MiyasakiEmail author


Parkinson disease (PD) has a variable duration of years to decades with anticipated progression of both motor and nonmotor symptoms. PD is listed by the Centers for Disease Control as the 14th leading cause of death. Prevalence increases with age, and trends of aging in the global population ensure that healthcare professionals will encounter PD increasingly over the coming decades. Consideration of multiple systems (neurobehavioral, autonomic, pain, dysphagia) and the balance between motor benefit and control of other symptoms is required. Based on the complexity of this illness, its progressive nature and effects on mortality, use of palliative care is appropriate to manage complex symptoms, address caregiver and family needs, and elicit goals of care. This chapter will discuss approaches to common nonmotor symptoms including dysautonomia, cognitive dysfunction, behavioral abnormalities, sleep and pain. Recommendations for weaning dopaminergic medications in advanced disease are reviewed noting that abrupt cessation or withholding levodopa is contraindicated at all stages of PD. We discuss prognostic indicators and when enrolment in hospice should be considered.


Parkinson disease Movement disorders Advanced stage Non-motor symptoms Palliative care Dementia Psychosis Patient-centered 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Medicine, Division of Neurology, Parkinson and Movement Disorders Program and the Complex Neurologic Symptoms Clinic, Kaye Edmonton ClinicUniversity of AlbertaEdmontonCanada

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