Adjunctive therapy in Parkinson's disease: the role of rasagiline

Kathryn D Gaines,1 Vanessa K Hinson21Department of Neurology, Aurora Advanced Healthcare, Milwaukee, WI, 2Department of Neurosciences, Movement Disorders Program, Medical University of South Carolina, Charleston, SC, USAAbstract: Parkinson's disease is the second most common neurodegenerative disorder, currently affecting 1.5 million people in the US. In this review, we describe the diagnostic and pathological features of Parkinson's disease, as well as its clinical course. We then review pharmacologic treatments for the disease, with a particular focus on therapies adjunctive to levodopa and specifically the role of rasagiline. We review the four pivotal rasagiline trials, and discuss rasagiline and its use as adjunctive therapy for Parkinson's disease. Finally, we discuss potential side effects, drug interactions, and other practical aspects concerning the use of rasagiline in Parkinson's disease.Keywords: Parkinson's disease, treatment, rasagiline, clinical trial

A case of maternal herpes simplex virus encephalitis during late pregnancy

BACKGROUND: A pregnant 25-year-old woman at 32 weeks' gestation was admitted to an emergency unit after her husband had found her drowsy and with her tongue bitten. The day before admission, the patient had developed a fever of 39 degrees C, was suffering from headaches, was nauseated and had vomited. On admission, she had anterograde and retrograde amnesia, but no somatic neurological deficits were detected. INVESTIGATIONS: Routine laboratory testing, lumbar puncture, cerebrospinal fluid analysis, routine bacteriology, brain MRI, and polymerase chain reaction testing for neurotropic viruses including herpes simplex virus types 1 and 2. DIAGNOSIS: Maternal herpes simplex virus type 1 encephalitis. MANAGEMENT: Antiviral and anticonvulsive therapy, supportive treatment, and cesarean section