帕金森病的诊断和治疗(德国神经病学学会指南)。

Günter Höglinger, Claudia Trenkwalder
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引用次数: 0

摘要

导言:本德国国家指南旨在优化帕金森病(PD)患者在诊断、药物和手术治疗及护理方面的临床治疗。本指南由德国神经病学学会 (DGN) 与奥地利神经病学学会 (ÖGN)、瑞士神经病学学会 (SNG) 合作编写,适用于德语区国家。PD 诊断和治疗指南已由国家专家组和 DGN 的 S2k 级指南委员会进行了修订。这些指南的主要目的是优化对帕金森病患者的临床诊断护理,包括早期发现、技术诊断检查、药物治疗和侵入性治疗方案:更新后的帕金森病诊断和治疗指南强调优化临床护理。主要修订包括倾向于使用 "帕金森病 "这一名称而非之前的术语,并采用国际帕金森和运动障碍协会(MDS)的诊断标准。建议涵盖基因和影像诊断、考虑疗效和患者因素的初始药物治疗,以及针对并发症的定制药物组合。指南还包括认知、情感、精神和自主神经症状的管理,以及泵疗法和脑深部刺激等非口服疗法。指南还涉及运动性危机、驾驶能力和护理理念等特殊情况,确保对处于不同阶段和病情的帕金森病患者进行全面管理:本指南反映了 2024 年初的技术水平。
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Diagnosis and treatment of Parkinson´s disease (guideline of the German Society for Neurology).

Introduction: The aim of this German national guideline is to optimize the clinical care of patients with Parkinson's disease (PD) in terms of diagnostics, drug and surgical treatment and care. This guidance was prepared for the German Society of Neurology (DGN) in collaboration with the Austrian Society of Neurology (ÖGN) and the Swiss Neurological Society (SNG) for German-speaking countries. The guidelines for the diagnosis and treatment of PD have been revised by a national expert group and the guideline commission of the DGN at S2k level. The main objective of these guidelines is to optimize the clinical care of PD patients regarding diagnosis, including early detection, technical diagnostic examinations, and pharmacological as well as invasive treatment options.

Recommendations: The updated PD diagnosis and treatment guidelines are emphasizing optimized clinical care. Key revisions include preferring the name "Parkinson's disease" over previous terms and adopting International Parkinson and Movement Disorder Society (MDS) diagnostic criteria. Recommendations cover genetic and imaging diagnostics, initial pharmacotherapy considering efficacy and patient factors, and tailored pharmacological combinations for complications. Guidelines extend to managing cognitive, affective, psychotic, and autonomic symptoms, along with non-oral therapies like pump therapy and deep brain stimulation. Special situations like akinetic crisis, driving ability, and care concepts are addressed, ensuring comprehensive management for PD patients at various stages and conditions.

Conclusions: This guidance reflects the state of the art at the beginning of 2024.

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