[Outpatient care of patients with Parkinson disease]. / Asistencia extrahospitalaria a pacientes con enfermedad de Parkinson.

INTRODUCTION: Some neurology clinics have been set up in specialist centres during the last ten years and their activities described. The group of patients with Parkinson's disease attended in the clinics of specialist centres have the distinguishing feature of where they are treated, which makes them different to other groups with the same disorder. OBJECTIVE: In this article we describe the general data of neurological attention for patients with Parkinson's disease, seen in two clinics belonging to specialist centres. PATIENTS AND METHODS: This article is based on records of patients made by neurologists of two structured centres in Hospital La Fe. RESULTS: In a period of 18 months 228 patients with Parkinson's disease were recorded out of a total case register of 5,101. Patients with Parkinson's disease made up between 4% and 5% of the patients attending the clinic. Between 30% and 50% of the patients seen in these clinics were evaluated only once during the period recorded. CONCLUSIONS: There seems to be a large number of cases recorded and these represent 70% of the estimated number of cases in the area. It seems that some patients do not keep in contact with the neurologist. Differences in function noted in clinics of specialist centres, between each other and compared with hospitals, are due to specific organizations and structures.

[New forms of Parkinsonism in hospice care]. / Parkinsonismos de novo en ámbito extrahospitalario.

Parkinson's disease is a well known phenomenon with characteristic evolution and clinical picture although having considerable variation in its presenting symptoms. From an extra-hospital consulting room we carried out a study of the characteristics of the clinical presentation of parkinsonisms in a series of one hundred cases so diagnosed from onset. The average age of the patients was around 66 years with a slight female predominance. Most patients had been referred to us by their own GPs. Some 70% of patients came suffering from shaking, 23% for slowness or clumsiness and 10% for unsteadiness. 71% of cases had unilateral onset and 29% had bilateral onset. Most of the patients we saw arrived at level 2 on the Hoehn and Yahr scale. The duration of the symptoms was approximately one year. In some 27% of cases drug consumption might have brought on parkinsonism. Almost two-thirds of these cases brought about by medicaments were being treated with cinaricine or flunaricine and nearly one third were undergoing neuroleptic treatment. Practically one out of every four cases, and one out of three women, could be considered as having iatrogenic parkinsonism. The onset of shaking with bilateral affectation is particularly suggestive of drug induced parkinsonism.