[Parkinson's disease here and now, a study of 50 cases]

Over more than ten years, the pathophysiological conceptions as well as the management of the idiopathic Parkinson's disease have considerably improved. We present a study of 50 patients examined during the year 2007 which represent a "cliché" of the pathology current in our area. These patients, whose pathology has been developing since 1 to 16 years (5,5 years average) are still for the time being in an acceptable functional stage. Their motor complications (fluctuations and dyskinesias) do not occur before a period of 5 years; they affect only about 25% of patients and do not engender serious disabilities in most cases. The non-motor symptoms often occur and are developed in our study. These symptoms need to be detected and treated efficiently. Some of these non-motor symptoms (olfactory troubles, rapid eye movement sleep behaviour disorder) are quite specific and can be noticed at the preclinical stage. Depression affects 20 % of the patients whereas dementia is relatively seldom (4 cases). The development of dementia is tied up to the duration of evolution, the age and sex. Levodopa treatment remains the basis for such a disease. After a period of a few years dopamine agonists and catechol-O-methyl transferase inhibitors are combined to Levodopa. A discussion compares our results to the recent literature and provides an overview of the present knowledge concerning this disease.