A Breathtaking Evolution of Therapeutic Approaches

By Stephen M. Gollomp, MD

The recent evolution of therapeutic ap-proaches to movement disorders has been almost breathtaking and a bit disorienting. That is why we thought it was time to dedicate an issue to the topic. We have enlisted, and are grateful for, the generous assistance of a diverse group of dedicated experts in the field.

The great promise of earlier identification and potential implementation of disease-modifying treatments have been a major focus of recent Parkinson’s disease (PD) investigation, capably surveyed by Drs. Morley and Mantri. It is an up-to-the minute piece that will convey the excitement that this new information is engendering.

Current pharmaceutical and interventional treatment of PD is ever more diverse. Treatment choices require nuanced assessment by the clinician, with an eye toward tailoring treatment to the needs, preferences, and tolerances of individual patients. Drs. Buyan-Dent, Mangin, and Shannon’s pharmaceutical survey and Drs. Forbes, Shah and Kern’s interventional approaches will really put this in perspective to help you make reasoned therapeutic decisions.

Drs. Witek and Comella’s piece emphasizes the importance of holistic treatment of PD by providing a comprehensive survey of the evidence for benefits of exercise for disease treatment. As we have known for some time, treating patients with PD is not purely pharmaceutical or surgical. This masterful survey equips you with the latest information to intelligently advise patients and caregivers about the benefits of appropriate exercise in a comprehensive approach to treatment.

Holistic treatment of PD must include confronting a variety of behavioral and cognitive issues, which are challenging for patient, caregiver, and physician. Drs. Pontone and Weiss masterfully review this area and provide useful approaches to these difficult matters.

Dr. Frucht lends his extensive expertise in the diagnosis of tremor to our publication. Tremor is the most common of all movement disorders, frequently leading referring physicians and patients to seek expert guidance about these problems. Equipping you with the latest diagnostic approaches will inevitably improve the quality of the advice you provide.

Very recently, there have been a number of therapeutic options introduced for the treatment of patients with chorea, dykinesias, and other hyperkinetic movement disorders. Dr. Bahroo expertly guides us through these new alternatives.

Finally, and a bit titillatingly, Drs. Maxwell and Farmer lead us through the science of cannabinoids and their potential application in the treatment of PD. Any physician treating patients with PD will inevitably be asked about the use of medical marijuana. Being equipped with objective information will assist you in properly advising your patients.

We trust that you will find this issue enlightening, helpful and entertaining. As always, your feedback is always appreciated.

Stephen M. Gollomp, MD
Clinical Professor of Neurology
Thomas Jefferson University
Chief of Neurology
Lankenau Hospital
Philadelphia, PA


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About Practical Neurology

Launched in 2002, Practical Neurology is a publication uniquely dedicated to presenting current approaches to patient management, synthesis of emerging research and data, and analysis of industry news with a goal to facilitate practical application and improved clinical practice for all neurologists. Our straightforward articles give neurologists tools they can immediately put into practice.