Guideline Issued for Treating Sleep, Constipation, Sexual Problems in Parkinsonís Disease
 
Published Wednesday, March 24, 2010 4:00 am

ST. PAUL, Minn. Ė The American Academy of Neurology has issued a new guideline recommending the most effective treatments to help people with Parkinsonís disease who experience sleep, constipation, and sexual problems, which are common but often underrecognized symptoms. The guideline is published in the March 16, 2010, issue of Neurologyģ, the medical journal of the American Academy of Neurology.

ďWhile the main symptom of Parkinsonís disease is movement problems, there are many other symptoms to be aware of, including sleep disorders, constipation, and problems with urination and sexual function,Ē said lead guideline author Theresa A. Zesiewicz, MD, with the University of South Florida in Tampa and a Fellow of the American Academy of Neurology. ďWithout treatment, these symptoms can cause as much pain and discomfort as movement problems and greatly affect daily routines and quality of life.Ē

Sexual problems often affect people with Parkinsonís disease. In men with Parkinsonís, erectile dysfunction is common. According to the guideline, the drug sildenafil citrate may improve erectile dysfunction. The guideline also found the drug isosmotic macrogol may improve constipation in people with Parkinsonís disease.

For problems with excessive daytime sleepiness, the guideline recommends that doctors consider the drug modafinil to help people feel more awake. However, itís important to note that one study showed people taking modafinil had a false sense of alertness. This may pose a safety risk for activities such as driving. The guideline also found the drug methylphenidate may help with fatigue.

The guideline mentions two tests to help identify nonmotor symptoms of Parkinsonís disease. One is the NMSQuest rating scale. The other is the Unified Parkinsonís Disease Rating Scale (UPDRS). The original UPDRS mainly tests for movement problems. Doctors use the updated version of the UPDRS to test for all Parkinsonís symptoms, including those unrelated to movements. People with Parkinsonís disease should talk to their doctor about whether these tests may be helpful.

ďMore research is needed into these symptoms of Parkinsonís disease since there are still a lot of unknown answers as to what causes these symptoms and how they can best be treated to improve lives,Ē said Zesiewicz.

The American Academy of Neurology, an association of more than 22,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Parkinsonís disease, ALS (Lou Gehrigís disease), dementia, West Nile virus and ataxia. For more information about the American Academy of Neurology, visit http://www.aan.com.
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