The list of treatments mentioned in various sources for Wolf-Parkinson-White syndrome includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.
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Because Parkinson’s disease has no cure, the primary aim of treatment is to relieve symptoms and keep the patient functional as long as possible. Treatment consists of drugs, physical therapy and, in severe disease states unresponsive to drugs, stereotactic neurosurgery or the controversial treatment called fetal cell transplantation. In this treatment, fetal brain tissue is injected into the patient’s brain. If the injected cells grow within the recipient’s brain, they will allow the brain to process dopamine, thereby either halting or reversing disease progression. Neurotransplantation techniques, including the use of nerve cells from other parts of the patient’s body, have been attempted with varying results.
Drug therapy usually includes levodopa, a dopamine replacement that’s most effective during early stages. It’s given in increasing doses until symptoms are relieved or adverse effects appear. Because adverse effects can be serious, levodopa is frequently given in combination with carbidopa to halt peripheral dopamine synthesis. Occasionally, levodopa proves ineffective, producing dangerous adverse effects that include postural hypotension, hallucinations, and increased libido leading to inappropriate sexual behavior. In that case, alternative drug therapy includes anticholinergics such as trihexyphenidyl, antihistamines such as diphenhydramine, and amantadine, an antiviral agent.
Research on the oxidative stress theory has caused a controversy in drug therapy for Parkinson’s disease. Traditionally, levodopa-carbidopa has been a first-line drug in management; however, it has also been associated with an acceleration of disease process. Inclusion of entacapone potentiates the effects of levodopa-carbidopa treatment so that less frequent doses are required.
Selegiline, an enzyme-inhibiting agent, allows conservation of dopamine and enhances the therapeutic effect of levodopa. Selegiline used with tocopherols delays the time when the patient with Parkinson’s disease becomes disabled.
When drug therapy fails, stereotactic neurosurgery, such as subthalamotomy and pallidotomy, may be an alternative. In these procedures, electrical coagulation, freezing, radioactivity, or ultrasound destroys the ventrolateral nucleus of the thalamus to prevent involuntary movement. This is most effective in young, otherwise healthy people with unilateral tremor or muscle rigidity. Neurosurgery can only relieve symptoms. Brain stimulator implantation alters the activity of the area where Parkinson’s disease symptoms originate. A pacemaker is implanted into the chest wall, and the electrode is threaded (using magnetic resonance imaging for guidance) to the thalamus, pallidum, or subthalamic nucleus. A successful procedure reduces the need for medication, thus reducing the medication-related adverse effects experienced by the patient.
Individually planned physical therapy complements drug treatment and neurosurgery to maintain normal muscle tone and function. Appropriate physical therapy includes both active and passive range-of-motion exercises, routine daily activities, walking, and baths and massage to help relax muscles.
Source: Professional Guide to Diseases (Eighth Edition), 2005
Because there’s no cure for Parkinson’s disease, the primary aim of treatment is to relieve symptoms and keep the patient functional as long as possible. Treatment consists of drugs, physical therapy and, in those unresponsive to drugs, stereotactic neurosurgery.
Drug therapy usually includes levodopa, a dopamine replacement that’s most effective during the early stages. It’s given in increasing doses until symptoms are relieved or the patient has an adverse reaction to it. Because adverse reactions can be serious, levodopa is commonly given with carbidopa to halt peripheral dopamine synthesis.
When levodopa proves ineffective or too toxic, alternative drug therapy includes anticholinergics such as trihexyphenidyl, antihistamines such as diphenhydramine, and antivirals such as amantadine. Selegiline, an enzyme-inhibitor, helps conserve dopamine and enhances the therapeutic effect of levodopa.
Treatment may include dopamine agonists, such as bromocriptine and ropinirole, which act directly on dopamine receptors. Catechol-O-methyltransferase inhibitors, such as entacapone and tolcapone, are given with dopamine; this new class of drugs blocks an enzyme that breaks down peripheral levodopa.
UNDER STUDY: Research on the oxidative stress theory has caused a controversy in drug therapy for Parkinson’s disease. Although levodopa (with carbidopa) has traditionally been a first-line drug in management of the disease, the drug has also been associated with an acceleration of the disease process. Selegiline followed by levodopa (with carbidopa) may provide increased protection.
When drug therapy fails, stereotactic neurosurgery may be an alternative. With this procedure, electrical coagulation, freezing, radioactivity, or ultrasound destroys the ventrolateral nucleus of the thalamus to prevent involuntary movement. It’s most effective in young, otherwise-healthy persons with unilateral tremor or muscle rigidity; however, neurosurgery can help by relieving symptoms.
Deep brain stimulation is another procedure that may be performed to relieve symptoms. This procedure involves implanting an electrode in the affected area of the brain. The electrode is powered by a battery pack similar to those used with cardiac pacemakers.
Individually planned physical therapy complements drug treatment and neurosurgery to maintain normal muscle tone and function. Appropriate physical therapy includes active and passive range-of-motion exercises, routine daily activities, walking, and baths and massage to help relax muscles.
Source: Handbook of Diseases, 2003
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