ABSTRACT
Levodopa should generally be avoided early in the course of Parkinson disease; dopamine agonists, particularly second-generation agents such as ropinirole (Requip) and pramipexole (Mirapex), carry a smaller long-term risk of dyskinesia and should be used instead. Deep brain stimulation is remarkably effective in refractory cases and may well usher in a new era in the treatment of chronic neurologic disease.
Footnotes
↵* The author has indicated that he has received grant or research support from Medtronic, Inc., serves as a consultant for Medtronic, Inc., and is on the speakers’ bureaus of the Medtronic, GlaxoSmithKline, and Pharmacia corporations. This paper discusses therapies that are investigational or are not approved by the US Food and Drug Administration for the use under discussion.
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