Parkinson-Syndrome in der Neurorehabilitation.

Parkinson syndromes play an important role in clinical neurology and are often caused by neurodegenerative disorders such as Parkinson's disease (PD), multiple system atrophy (MSA) or progressive supranuclear palsy (PSP). The cardinal symptoms of PD akinesia, rigidity and rest tremor respond usually well to drug therapy. However, motor fluctuations frequently occur as a long-term complication of pharmacological therapy. Besides axial symptoms such as hypophonia, dysphagia, impairment of postural control or stability and freezing, that often do not improve by medication, become more predominant. In MSA and PSP the response to drug therapy is usually poor. Therefore non-pharmacological approaches such as neurorehabilitation gain increasingly in importance in the treatment of Parkinson syndromes, although evidence especially in the atypical forms remains quite limited. Besides pump therapies (apomorphine, Duodopa (R)) and the follow-up treatment of PD patients after deep brain stimulation are frequently performed in specialized neurorehabilitation clinics.