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Relax... you bring the coffee... we'll do the rest
Relax... you bring the coffee... we'll do the rest



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Management of mid and late stage idiopathic Parkinson’s disease (GLX-0006)
As idiopathic Parkinson’s disease progresses, non-motor symptoms come to the fore and motor complications become a treatment challenge. This module looks at the common motor and non-motor complications experienced by patients with advanced idiopathic Parkinson’s disease. Motor complications include dyskinesias, ‘wearing-off’, fluctuations and ‘freezing’. While non-motor complications include depression, psychosis, dementia, hypersalivation and hypotension. Options for balancing medications to allow the patient the best quality of life are explored using realistic cases.

Learning Objectives:

  • Be familiar with the most common motor complications caused by the side effects of medication in idiopathic Parkinson’s disease
  • Understand the option of Deep Brain Stimulation in treating idiopathic Parkinson's disease
  • Be able to identify the most likely cause of a presenting motor complication in a patient with idiopathic Parkinson’s disease
  • Be able to adjust/change medication to provide increased ‘on’ time while reducing or limiting motor complications in a patient with idiopathic Parkinson’s disease
  • Be familiar with the most common non-motor complications caused by the side effects of medication in idiopathic Parkinson’s disease
  • Be able to adjust/change medication to provide increased ‘on’ time while reducing or limiting non-motor complications in a patient with idiopathic Parkinson’s disease
This online training program has been developed by the Medeserv education team, in partnership with A/Prof Martin Krause and Parkinson’s Australia. Parkinson’s Australia is the national voice for Australians living with Parkinson’s disease. The organisation strives to ease the burden and find a cure through advocacy, education, support services and research.

This project was funded by the Commonwealth Department of Health and Ageing and John T Reid Charitable Trusts.

Disclaimer
Every endeavour is made to ensure the quality and currency of information contained in this educational program. However, at any point in time, some of the details included in this program may not be up to date (especially in regard to drug information). Further, by it's nature, this educational program does not make recommendations about the care of individual patients and cannot be interpreted as substituting for the professional's responsibility to make judgements in any instance of care using the most up to date information from multiple available sources.

Content author and expert presenter
Associate Professor Martin Krause

A/Prof Martin Krause A/Prof Martin Krause graduated in 1995 from the medical school of the Ruprecht-Karls University of Heidelberg in south-western Germany, one of the oldest faculties in the world (founded in the 14th century). He completed his medical training at the University Clinics of Heidelberg.

Dr Krause’s scientific interests are movement disorders especially Parkinson’s disease, dystonia, and tremor. In 1996 he joined the research group of Professor Volker Tronnier, who was one of the first stereotactic neurosurgeons in Germany to use Deep Brain Stimulation for the treatment of chronic pain and movement disorders. This research group was one of the first to prove Deep Brain Stimulation to be an effective treatment of generalized dystonia.

Dr Krause is a founding member of the German Parkinson Society. He participated in the German Competence Network of Parkinson’s disease and was involved in the development of the German therapeutic guidelines for Parkinson’s disease. In 2006, he joined the Westmead Movement Disorder Research Group for a sabbatical research program investigating the effect of deep brain lesions on motor behaviour. In September 2007, he accepted the appointment as Associate Professor of Neurology in the medical faculty of the University of Sydney at Nepean Clinical School. Dr Krause has published over 25 scientific articles in international medical journals including three articles in the New England Journal of Medicine.

Expert presenter
Dr Simon Lewis MBBCh BSc MRCP MD

Simon Lewis is the Senior Lecturer of Cognitive Neuroscience at the University of Sydney. He is heading up the newly established Parkinson’s disease Research Clinic at the Brain and Mind Research Institute, University of Sydney and has also set up a Movement Disorders clinic at the Royal Prince Alfred Hospital in Sydney.

Before moving to Australia in 2007, he trained as a Neurologist at Cambridge and the National Hospital for Neurology and Neurosurgery, Queen Square, London. Prior to his clinical training he undertook research in Parkinson’s disease at the University of Cambridge, exploring the underlying causes for differing clinical symptoms using functional neuroimaging. Whilst in the UK he co-authored the book Parkinson’s Disease: Your Questions Answered written, which addresses the common concerns raised by patients and carers. He currently sits on the Parkinson’s NSW Advisory Committee.

Educators
Janine Roberts
Iain Packer

Education methodology and design
Professor Lynn Robinson
is Director of Education Innovation in the Centre for Health Innovations and Solutions, The University of Queensland.

Significant contributor and audience representative
Dr Natalie Burch (GP)

Dr Natalie Burch (B.Sc., M.B.B.S., DRANZCOG, FRACGP) works as a rural general practitioner in Scottsdale, Tasmania. Her special interests in medicine include mental health, family planning and low risk obstetrics, minor surgery and emergencies.

Acknowledgement
A sincere thank you to Professor John GL Morris for generously providing us with the use of his patient videos.
We gratefully acknowledge the patients who generously volunteered to be part of this project.

References
[1] Clarke CE. Parkinson’s disease. BMJ 2007;335:441-5.
[2] Dubois B, Burn D, Goetz C, Aarsland D, Brown RG, Broe GA et al. Diagnostic procedures for Parkinson's disease dementia: recommendations from the movement disorder society task force. Mov Disord 2007 Dec;22 (16):2314-24.
[3] Healthy Alliance. The Parkinson’s disease atlas. Hertfordshire: Mardeno; 2006.
[4] Poewe W. When a Parkinson's disease patient starts to hallucinate. Pract Neurol 2008 Aug;8(4):238-41.
[5] Weintraub D, Hurtig HI. Presentation and management of psychosis in Parkinson's disease and dementia with Lewy bodies. Am J Psychiatry 2007 Oct;164(10):1491-8.

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Time: 1 hour 30 minutes
Catalogued by:
  • Clinical knowledge and skills
    • Neurological conditions
  • Clinical continuum
    • Management
    • Patient education
  • Units by type
    • Learning material
  • Level
    • Intermediate
  • RACGP Domains of General Practice
    • Applied professional knowledge and skills
  • ACRRM Educational Domains and Curriculum Areas of Rural & Remote Medicine
    • Aged Care (Area)
    • Management (Area)

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