Continuum, February 2007, Volume 13, Issue 1

Parkinson's disease is a neurodegenerative disease characterized by a loss of dopaminergic neurons in the substantia nigra pars compacta. Motor symptoms include bradykinesia, rigidity, and tremor. Treatment of motor symptoms focuses on reducing these symptoms while minimizing short-term side effects and avoiding long-term motor complications (motor fluctuations and dyskinesia). Nonmotor symptoms include cognitive dysfunction, sleep disorders, fatigue, depression, and autonomic abnormalities. Treatment of nonmotor symptoms focuses on specific symptomatic therapy. Currently no treatment has been proven to slow progression of Parkinson's disease, but this is an area of active research.A series of cases throughout the chapter represents a progression of disease severity and treatment complexity.(C) 2007 American Academy of Neurology

Tremor, a rhythmic and oscillatory movement, is commonly encountered in clinical practice. The focus of this chapter is the treatment of nonparkinsonian tremors. While the most common of these tremor disorders is essential tremor, the treatment of other disorders (eg, dystonic tremor, cerebellar tremor, orthostatic tremor) is discussed as well. The treatment of a given tremor disorder involves the use of selected medications and, in the setting of severe, medically refractory movements, the use of surgery.(C) 2007 American Academy of Neurology

Numerous therapies are potentially useful in the management of patients with dystonia. In this chapter, the available therapeutic options are reviewed, including modalities that have entered the clinician's armamentarium relatively recently, with emphasis on the selection of an approach tailored to the individual patient's specific considerations.(C) 2007 American Academy of Neurology

Tics are common in children and often lead to only minimal disability. Tourette syndrome and more disabling tic disorders are rare in children. Therefore, most tic disorders will not progress to sufficient severity to require treatment. For those children who do require treatment, several options exist. The most effective medications are the neuroleptics, but these are often reserved for more severe or refractory cases due to the potential for permanently disabling side effects. This chapter discusses the diagnosis and treatment of tic disorders in children.Continuum: Lifelong Learning Neurol 2007;13(1):139-153.(C) 2007 American Academy of Neurology