Diagnosis and pharmacological management of Parkinson's disease: summary of SIGN guidelines

Abstract

Parkinson’s disease is a common neurodegenerative disease diagnosed in 1% of people aged over 65 years. It has a considerable impact on patients and their families as well as healthcare and social care systems. With an ageing population, the number of cases in Scotland may increase by 30% in the next 25 years.1 Accurate diagnosis can be difficult, particularly at first presentation. As the disease progresses, treatment with complex combinations of drugs often becomes the norm. This article summarises the recommendations from the Scottish Intercollegiate Guideline Network (SIGN) on the diagnosis and drug management of Parkinson’s disease.2 SIGN recommendations are based on systematic reviews of best available evidence. The strength of the evidence is graded as A, B, C, or D (fig 1⇓), but the grading does not reflect the clinical importance of the recommendation. Recommended best practice (“good practice points”), based on the clinical experience of the Guideline Development Group, is also indicated (as GPP). Explanation of SIGN grades of recommendations ### Diagnosis