The mainstay of treatment for Parkinson’s Disease (PD) remains symptomatic despite the rapid
expansion in knowledge of its neurodegenerative process. Therapeutic options, both medical and surgical,
have been markedly improved over the past decades, resulting in better motor function, activities of daily
living, and quality of life for PD patients. The principle of PD management should be individualized and the
selection of treatments should aim to control symptoms as well as to prevent or delay motor complications. In
Thailand, various pharmacologic and surgical options are available, including different formulations of
levodopa, dopamine agonists, monoamine oxidase B inhibitor, cathechol-O-methyltransferase inhibitor,
pallidotomy, and lastly deep brain stimulation. The use of dopamine agonists in early PD has a levodopasparing
effect and reduces the incidence of motor complications. Continuous dopaminergic stimulation (CDS),
which mimics physiological activation of dopaminergic receptors, has been proposed as a strategy to prevent
motor complications. Based on current evidence, practical guidelines in the medical management of different
types of motor complications are outlined in the present article according to what are available in Thailand.
Surgical interventions should be reserved for patients with intractable motor complications after careful
patient selection.

Keywords: Parkinson’s Disease, Motor complications, Deep brain stimulation