1Department of Neurology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
2Department of Internal Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
3Division of Neurology, Department of Internal Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
Copyright © 2021 The Korean Movement Disorder Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflicts of Interest
The authors have no financial conflicts of interest.
Author Contributions
Conceptualization: Yue Hui Lau, Norlinah Mohamed Ibrahim. Data curation: all authors. Formal analysis: all authors. Investigation: all authors. Methodology: all authors. Project administration: all authors. Resources: all authors. Software: Keng Ming Lau. Supervision: Norlinah Mohamed Ibrahim. Validation: all authors. Visualization: Yue Hui Lau, Keng Ming Lau. Writing—original draft: Yue Hui Lau, Norlinah Mohamed Ibrahim. Writing—review & editing: Yue Hui Lau, Keng Ming Lau.
Use of telemedicine | |
Optimization of motor and non-motor symptoms [19] | |
Adjustments for medication-related side effects [19] | |
Reliable to assess Motor section of the Unified Parkinson’s Disease Rating Scale (UPDRS-III) [25] | |
Speech therapy, physiotherapy and rehabilitation services [30] | |
Alternatives: Wearable devices and smartphone applications, or Phone calls or patient-recorded videos, sent via text messaging | |
Deep brain stimulation surgery (DBS)/therapy | |
Selective DBS for PD patients with urgent indication | |
Post-operative follow-up for suture removal and stimulation settings should be timed appropriately | |
Urgent intervention for end of battery life of the implantable pulse generator, leads fracture and infection related to lead implantation [23,25,31,32] | |
Medications | |
Caution of drug interaction with PD medication [33] | |
Avoid abrupt cessation of PD medications [31] | |
Highly fractionated doses of levodopa solution can be given via a nasogastric tube [31] | |
Apomorphine pump therapy and levodopa/carbidopa intestinal gel (LCIG) continuous infusion can be continued [31] | |
Intravenous amantadine is less efficacious [31] | |
Sequential withdrawal of anticholinergics, MAO-B inhibitors and COMT-I is recommended for psychosis and delirium related to infection | |
Sequelae of Parkinsonism in COVID-19 | |
The need of proper registry for prevalence/incidence | |
The use of biomarker (e.g., neurofilament light chain for signs of neurodegeneration [40]) | |
Vaccination | |
Recommended in PD patients [42] | |
Do not interfere with the current PD medication [42] | |
Not known to interact with the neurodegenerative process in PD [42] | |
Research | |
Non-clinical or clinical studies without direct contact with patients should be prioritized [46] | |
Encourage studies related to preventive, diagnostic and interventional measures [47] | |
Enhance the international collaboration in PD research [47] | |
Application of artificial Intelligence with an integrated-omics approach [49,50] |