Neurodegenerative Disease Management Practice Test

A 68-year-old man with a 10-year history of Parkinson's disease reports worsening motor symptoms. He is maintained on carbidopa/levodopa 25/100, two tablets four times daily. For the past year, he has experienced predictable 'off' periods beginning 3-4 hours after each dose, during which he has significant bradykinesia and rigidity, making it difficult to walk. He has no significant dyskinesias. He asks about options to make his medication work more consistently throughout the day.

A 58-year-old man diagnosed with amyotrophic lateral sclerosis (ALS) 18 months ago presents for a follow-up appointment. He reports increasing difficulty swallowing solids and has had several episodes of coughing and choking during meals. He has lost 4.5 kg (10 lbs) over the past 3 months. He is currently taking riluzole. His respiratory function is stable.