Differenzialtherapie in der Spätphase des Morbus Parkinson

Einleitung

Spätphase wird definiert als fortgeschrittener idiopathischer Morbus Parkinson mit motorischen Komplikationen und oft vorhandener Multimorbidität im höheren biologischen Alter. Störungen der parkinsonassoziierten vegetativen Regulation erfordern ein in enger Kooperation mit Kollegen anderer Fachrichtungen abgestimmtes Therapiemanagement. In der Spätphase beeinträchtigen im Wesentlichen nichtmotorische Symptome, wie Psychose, Demenz, Depression und Schlafstörungen, die Lebensqualität. Auch ist eine adäquate, den Patienten zufrieden stellende, medikamentöse Einstellung der Motorik mit Optimierung der Medikation wegen des Auftretens von Dyskinesien und motorischen Fluktuationen, die vorhersagbar und unvorhersagbar sein können, oft problematisch [1] [2]. In der folgenden Übersicht werden Therapievorschläge dazu unterbreitet.

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