[Management of Parkinson's disease in 2009]

The cause of Parkinson's disease remains unknown and no cure or prevention exists so far. Levodopa remains by far the most potent symptomatic therapy, but induces side-effects such as motor fluctuations and abnormal movements, which can somewhat be counterbalanced by optimizing levodopa plasma levels or acting at receptors level with long half-life dopamine agonists. In severe cases, functional surgery with deep brain stimulation can be offered. Some non-dopaminergic symptoms like dementia, freezing, postural instability or dysautonomia do not respond to dopaminergic drugs and need special care.