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Parkinson's disease - Management
How do I manage worsening motor symptoms and motor complications?
- Worsening motor symptoms or motor complications may include:
- Deteriorating function — immobility, slowness, withdrawal from activities, communication difficulties.
- Loss of drug effect.
- Motor fluctuations — end-of-dose fading (wearing off), on-off phenomenon (rapid and unpredictable fluctuations between 'on' and 'off' periods), or dose failures.
- Dyskinesia (involuntary movements) — chorea (quick fidgety movements) or dystonia (slow, distorted postures).
- Freezing of gait.
- Falls.
- Look for and treat any acute illness (such as an infection or constipation) that could be exacerbating motor symptoms.
- Check adherence with anti-parkinsonian medication, including the correct doses and timings.
- If symptoms or complications persist, contact the person's Parkinson's disease specialist team for advice (on changes to treatment), or make an interim referral.
Basis for recommendation
These recommendations are based on a guide for primary care teams developed by the Parkinson's Disease Society [Parkinson's Disease Society, 2003], with examples of symptoms derived from an evidence-based review [Pahwa et al, 2006].
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