FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 353:1021-1027 September 8, 2005 Number 10 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF PDA Full Text Supplementary Video Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

A 62-year-old man presents with an intermittent tremor in his left hand and some vague discomfort in the left arm. Physical examination shows a minimal rest tremor in the left hand that disappears with use of the limb, mild rigidity at the left wrist and elbow, slowness of finger tapping with the left hand, and decreased arm swing on the left while . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Diagnosis

Differential Diagnosis

Nonpharmacologic Management

Pharmacologic Therapy

            Levodopa

            Dopamine Agonists

            Other Pharmacologic Agents

Surgical Therapy

Areas of Uncertainty

Possible Neuroprotective Therapies

Timing of the Initiation of Levodopa

Choice of Initial Therapy

Guidelines

Summary and Recommendations

Source Information

From the Department of Neurology, Oregon Health and Science University, Portland (J.G.N.); and the Department of Neurology, University of Virginia, Charlottesville (G.F.W.).

Address reprint requests to Dr. Nutt at the Department of Neurology, Oregon Health and Science University, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97239, or at nuttj@ohsu.edu.

This article has been cited by other articles:

• Lancellotti, P., Livadariu, E., Markov, M., Daly, A. F, Burlacu, M.-C., Betea, D., Pierard, L., Beckers, A. (2008). Cabergoline and the risk of valvular lesions in endocrine disease.. Eur J Endocrinol 159: 1-5 [Abstract] [Full Text]  
• Cooper, M. K, Brock, D. G, McDaniel, C. M (2008). Interaction Between Levodopa and Enteral Nutrition. The Annals of Pharmacotherapy 42: 439-442 [Abstract] [Full Text]  
• Schade, R., Andersohn, F., Suissa, S., Haverkamp, W., Garbe, E. (2007). Dopamine Agonists and the Risk of Cardiac-Valve Regurgitation. NEJM 356: 29-38 [Abstract] [Full Text]  
• Barbic, F., Perego, F., Canesi, M., Gianni, M., Biagiotti, S., Costantino, G., Pezzoli, G., Porta, A., Malliani, A., Furlan, R. (2007). Early Abnormalities of Vascular and Cardiac Autonomic Control in Parkinson's Disease Without Orthostatic Hypotension. Hypertension 49: 120-126 [Abstract] [Full Text]  
• Tan, E.-K., Jankovic, J. (2006). Genetic testing in Parkinson disease: promises and pitfalls.. Arch Neurol 63: 1232-1237 [Full Text]  
• Okun, M. S., Fernandez, H. H., Rodriguez, R. L., Romrell, J., Suelter, M., Munson, S., Louis, E. D., Mulligan, T., Foster, P. S., Shenal, B. V., Armaghani, S. J., Jacobson, C., Wu, S., Crucian, G. (2006). Testosterone Therapy in Men With Parkinson Disease: Results of the TEST-PD Study.. Arch Neurol 63: 729-735 [Abstract] [Full Text]  
• Mendell, J. R., Clark, K. R. (2006). Risks, benefits, and consent in the age of gene therapy. Neurology 66: 964-965 [Full Text]  
• Hudry, J., Rinne, J. O, Keranen, T., Eckert, L., Cochran, J. M (2006). Cost-Utility Model of Rasagiline in the Treatment of Advanced Parkinson's Disease in Finland. The Annals of Pharmacotherapy 40: 651-657 [Abstract] [Full Text]