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- Treatment should start as early as possible, before the immune system is irreversibly damaged.
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Examples of cytotoxic antibiotics are doxorubicin, dactinomycin and bleomycin. Doxorubicin inhibits an enzyme called topoisomerase.
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Therapy therefore aims to improve dopaminergic transmission or inhibit cholinergic pathways to restore the balance. Idiopathic Parkinsons disease occurs due to degeneration of dopamine neurons with no obvious cause. There may be a genetic susceptibility, but no causal gene has been found, although mutation of the so-called Parkin gene is associated with early-onset Parkinsonism.
Authored by Naim S Issa, MD
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Discuss the treatment of this patient using the questions below as a guide. They are intended to stimulate discussion not limit debate.
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