Moving Forward, Together: Pain - The Invisible Symptom (2022)

Dr. Alfonso Fasano, a prominent neurologist and researcher, delivered this plenary talk addressing the often-overlooked issue of pain in Parkinson's disease. He highlighted the prevalence of pain as a symptom in Parkinson's and its various forms, including musculoskeletal, neuropathic, motor-related, and central pain. Dr. Fasano stressed the importance of education, accurate diagnosis, and personalized treatment approaches for managing pain in Parkinson's patients.

He discussed how Parkinson's disease could lead to shoulder pain, postural problems, and neuropathic pain, often exacerbated by long-term levodopa use and motor fluctuations. Pain-related issues like dopamine dysregulation syndrome, medication addiction, and dystonia were also addressed, with physiotherapy being a potential solution.

The talk emphasized the need to distinguish between Parkinson's-related pain and other causes, cautioning against the overuse of painkillers. Treatment options mentioned included dopamine agonists, levodopa patches, Deep Brain Stimulation (DBS), cannabinoids, and antidepressants. Dr. Fasano also discussed rescue medications like sublingual apomorphine and crushed levodopa for sudden off periods, along with treatments like botulinum toxin injections and DBS for dystonia. Advanced therapies like focused ultrasound were considered for specific pain types. Dr. Fasano also stressed the crucial role of caregivers in Parkinson's management and suggested testing for vitamin deficiencies as a potential treatment avenue.

**Disclaimer: These sessions are designed to provide general education and are not intended for individual advice and/or clinical care. The information conveyed in this recording was accurate at the time of presentation.**