journal - Canadian Guidelines on Parkinson’s Disease

1 F d rationdes sciencesneurologiquesdu CanadacanadianneurologicalsciencesFedera tionThejournalCanadian journal of Neurological SciencesThe official journal of:The Canadian Neurological Society, The Canadian Neurosurgical Society, TheCanadian Society of Clinical Neurophysiologists, The Canadian Association of Child NeurologyPM 40007777 R 9824AN INTERNATIONAL journal PUBLISHED BY THE Canadian NEUROLOGICAL SCIENCES FEDERATIONV olume 39 Number 4 (Supplement 4) July 2012 Canadian Guidelines on parkinson s Disease A Peer-reviewed SUPPLEMENT to The Canadian journal of Neurological SciencesThese Guidelines are endorsed by the Canadian Neurological Sciences FederationS1 Canadian Guidelines on parkinson s Disease IntroductionS2 Guideline Development Process S5 Communication Section 1S7 Diagnosis and Progression Section 2S10 General Treatment Considerations Section 3S10 Pharmacological Therapy for Motor Symptoms in Early PDSection 3AS11 Pharmacological Therapy for Motor Symptoms in Later PDSection 3BS12 Treatment - SurgerySection 3CS14 Treatment - Other Treatment

2 OptionsSection 3DS16 Non-Motor Features of PD - Mental Health Section 4S17 Sleep DisordersSection 4BS19 Autonomic Dysfunction Treatment - General ConsiderationsSection 4CS22 Supplemental TablesS24 Summary of Canadian Recommendations with ReferencesVolume 39 / Number 4 / Supplement 4 / July 2012F d rationdes sciencesneurologiquesdu CanadacanadianneurologicalsciencesFedera tionThejournalCanadian journal of Neurological SciencesEditor-in-Chief/R dacteur en chefG. Bryan Young LONDON, ONAssociate Editors/R dacteurs associ sJ. Max Findlay EDMONTON, ABTimothy J. Benstead HALIFAX, NSMike Poulter LONDON, ONSerge Gauthier VERDUN, QCRobert Hammond LONDON, ONMary Connolly VANCOUVER, BCPast Editors/Anciens r dacteurs en chefDouglas W.

3 Zochodne CALGARY, ABJames A. Sharpe TORONTO, ONRobert G. Lee CALGARY, ABRobert T. Ross WINNIPEG, MB(Emeritus Editor, Founding Editor) Editorial Board/Conseil d' ditorialJorge BurneoLONDON, ONRichard Desbiens QUEBECCITY, QCDavid Fortin SHERBROOKE, QCMark Hamilton CALGARY, ABHans-Peter Hartung DUSSELDORF, GERMANYM ichael Hill CALGARY, ABAlan C. Jackson WINNIPEG, MBDaniel Keene OTTAWA, ONJames Perry TORONTO, ONOksana Suchowersky CALGARY, ABBrian Toyota VANCOUVER, BCBrian Weinshenker ROCHESTER, MN, USAS amuel Wiebe CALGARY, ABElaine Wirrell ROCHESTER, MN, USASECTIONEDITORS/CONSEIL DE R DACTIONN euroimaging Highlight/NeuroimagerieDavid Pelz LONDON, ONNeuropathological Conference/Conf rence sur la neuropathologieRobert Hammond LONDON, ONBook Review/Critiques de livresReflections/RefletsAndrew Kirk SASKATOON, SKCritically Appraised Topic Summaries (CATS)

4 Jorge Burneo LONDON, ONMary Jenkins LONDON, ONEditorial Review Board/Conseil de Revue d' ditorialDonald Brunet KINGSTON, ONJodie Burton CALGARY, ABLionel Carmant MONTREAL, QCColin Chalk MONTREAL, QCK. Ming Chan EDMONTON, ABRobert Chen TORONTO, ONJoseph Dooley HALIFAX, NSPaolo Federico CALGARY, ABDaryl Fourney SASKATOON, SKHannah Glass SANFRANCISCO, CA, USAAlan Goodridge ST. JOHN S, NLIan Grant HALIFAX, NSAlan Guberman OTTAWA, ONJohn Hurlbert CALGARY, ABManouchehr Javidan VANCOUVER, BCPatrick McDonald WINNIPEG, MBMartin McKeown VANCOUVER, BCJoseph Megyesi LONDON, ONVivek Mehta EDMONTON, ABSteven Miller VANCOUVER, BCNeelan Pillay CALGARY, ABChristopher Power EDMONTON, ABAlex Rajput SASKATOON, SKJean Raymond MONTREAL, QCGary Redekop VANCOUVER, BCMark Sadler HALIFAX, NSHarvey Sarnat CALGARY, ABJohn Stewart VANCOUVER, BCJeanne Teitelbaum MONTREAL, QCEve Tsai OTTAWA, ONShannon Venance LONDON, ONMatt Wheatley EDMONTON, ABJerome Yager EDMONTON.

5 ABJournal Staff - Calgary, ABDan Morin, Chief Executive OfficerMaggie McCallion, Designer/Production CoordinatorCindy Leschyshyn, Editorial CoordinatorAdvertising representative/Repr sentant depublicit :Brett WindleCorporate Development CoordinatorTel (403) 229-9575 Fax (403) 229-1661E-mail: Graphics, 4501 Manitoba Road SE Calgary, Alberta T2G 4B9 The official journal of: / La Revue officielle de:The Canadian Neurological SocietyLa Soci t Canadienne de NeurologieThe Canadian Neurosurgical SocietyLa Soci t Canadienne de NeurochirurgieThe Canadian Society of Clinical NeurophysiologistsLa Soci t Canadienne de Neurophysiologie CliniqueThe Canadian Association of Child NeurologyL Association Canadienne de Neurologie P diatriqueThe permanent secretariat for the four societies and theCanadian Neurological Sciences Federation is at:Le secr tariat des quatre associations et du F d ration dessciences neurologiques du Canada est situe en permanence.

6 7015 Macleod Trail SW, Suite 709 Calgary, Alberta, Canada T2H 2K6 CNSF (403) 229-9544 / CJNS (403) 229-9575 Fax (403) 229-1661 The Canadian journal of Neurological Sciences is published bi-monthly. The annual subscription rate for Individuals (print andonline) are: C$ (Canada), C$ (US), C$ (International). Subscription rates for Institutions (print and online)are C$ (Canada), C$ (US), C$ (International). Online Only - Available only to International subscribers C$ (Individual), C$ (Institutional). See full details including taxes. Single copies C$ each plusC$ shipping and handling. E-mail: 2012 by THE Canadian journal OFNEUROLOGICAL SCIENCES INC.

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8 Visiter pourtous les d tails incluant les taxes. Exemplaires uniques : 30,00 $ Cl unit , plus 25,00 $ C en frais de port et de manutention. Courriel: COPYRIGHT 2012 du THE CANADIANJOURNAL OF NEUROLOGICAL SCIENCES INC. Tous droitsr serv s. Aucune partie de ce journal ne peut tre reproduite sousquelque forme que ce soit sans la permission pr alable du Journalde la F d ration des sciences neurologiques du Canada. Frais deport pay s Calgary, en journal is indexed by / Cette journal est cit et index dans:Adis International, ArticleFirst, BIOBASE, BiolAb, BiolSci, BIOSISPrev, Centre National de la Recherche Scientifique, CSA, CurAb,CurCont, De Gruyter Saur, E-psyche, EBSCO, Elsevier, EMBASE,FRANCIS, IBZ, Internationale Bibliographie der RezensionenGeistes-und Sozialwissenschaftlicher Literatur, MEDLINE,MetaPress, National Library of Medicine, OCLC, PE&ON, PersonalAlert, PsycFIRST, PsycINFO, PubMed, Reac, RefZh, SCI, SCOPUS,Thomson Reuters, TOCprem, VINITI RAN.

9 Web of 0317 - 1671 Volume 39 / Number 4 / Supplement 4 / July 2012F d rationdes sciencesneurologiquesdu CanadacanadianneurologicalsciencesFedera tionThejournalCanadian journal of Neurological SciencesSuppl. 4 - S1 The aim of the Canadian Guidelines on parkinson s Disease isto enhance the care for all Canadians with parkinson s Diseasethat: is based on the best published evidence involves expert consensus when there is a lack of evidence offers practical clinical advice takes into account patient choice and informed decision making is relevant to the Canadian Health Care SystemThe target users for the final document are health careprofessionals.

10 However, they may also be used by stakeholders(policy makers, funding bodies) and people with parkinson sdisease and their families. These recommendations are intendedto serve as a guide for health care providers, and clinicaldiscretion should be used by all who are following the CanadianParkinson s Guideline recommendations. The definitivejudgment is made by the appropriate healthcare professional(s)based on all the data available for an individual person. It isrecognized that resource problems may make it difficult to putinto practice every recommendation in these , they are meant to improve the standard of care andaccess to care for individuals with parkinson s in all regions ofCanada.