Parkinson’s Disease

This chapter on Parkinson’s disease discusses the epidemiology and clinical features of the disease. It also covers the pathophysiology and clinically relevant staging, as well as peri-operative considerations for the anaesthetist, including the effects of surgery and anaesthesia on various organ systems of the patient with Parkinson’s disease. The chapter also covers a range of appropriate drug treatments, including dopamine, dopamine agonists, monoamine oxidase-B inhibitors (MAO-B inhibitors), anticholinergic agents, NMDA antagonists, and catechol-O-methyl-transferase inhibitors (COMT inhibitors). Lastly, it discusses the treatment of Parkinson-associated depression, fatigue, dementia and psychosis, neuroleptic malignant syndrome (NMS), anaesthesia management, and implantation of deep brain stimulators.