A comprehensive approach to Parkinson's disease - How to manage fluctuating motor and nonmotor symptoms

Because of their close rapport with patients and their families, primary care physicians are in a unique position to provide comprehensive care for patients with Parkinson's disease. In this environment, they can monitor changes in motor status and prescribe drugs either alone or in consultation with neurologists and other specialists. Primary care physicians also can treat debilitating nonmotor symptoms of Parkinson's disease, such as chronic pain, autonomic dysfunction, mood disorders, sleep disturbances, and cognitive impairment. In this article, Dr Brunton describes the complex presentation of this disease, appropriate drug therapy, drug side effects, and neurosurgical techniques that may be used should drugs fail.