Neurol. praxi. 2009;10(6):363-368

Postural instability in patients with Parkinson’s disease and its treatment

MUDr.Peter Valkovič, PhD.^1,2

¹ II. neurologická klinika LF UK a FNsP Bratislava, Nemocnica akademika L. Dérera, Bratislava

² Ústav normálnej a patologickej fyziológie SAV, Bratislava

Postural instability (PI) is a cardinal sign of Parkinson’s disease (PD). Its importance increases along with the disease progression. Most

serious consequences of PI are recurrent falls, which extremely worsen quality of patients´ life, and complications of which increase

healthcare expenditures. Most of falls happens in patients’ home environment and in state of good mobility. Targeted history taking

and specified clinical neurological assessment is needed to detect and follow-up PI. Pharmacotherapy has only limited effect. Drugs

working predominantly through the noradrenergic neurotransmitter system seem to be promising. Long-term effect is expected from

brain stimulation of the pedunculopontine nucleus. Continuous „tailored“ physiotherapy plays a key role in the treatment of PI and fall

prevention in PD.

Keywords: postural instability, Parkinson’s disease, falls, treatment

Published: January 1, 2010  Show citation