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Managing patients with Parkinson disease is already complex, and functional symptoms produce another layer of complexity
Until recently the management of Parkinson disease focused almost entirely on the triad of bradykinesia, rigidity and tremor. It then became apparent that there are many non-motor features as well, and management of these is often as important as the motor symptoms. The work of Onofrj et al first reported that functional symptoms are also frequent in Parkinson disease.1 In a large study of 488 patients with Parkinson disease, 7.5% had some ‘somatoform disorders’, both motor and non-motor in type. They also noted that these symptoms could precede the motor and non-motor symptoms. The JNNP paper by Wissel et al 2 describes …
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