Update information

This guideline is an update of NICE guideline CG35 (published June 2006) and replaces it.

New recommendations have been added on treating Parkinson's disease symptoms, deep brain stimulation, monitoring and managing impulse control disorders, and palliative care. These are marked as [2017].

Where recommendations end [2006], the evidence has not been reviewed since the original guideline.

Recommendations that have been changed

Amended recommendation wording (change to meaning)

Recommendation in 2006 guideline

Recommendation in current guideline

Reason for change

1.2.5.1, 1.2.6.1, 1.2.7.1, 1.2.8.1, 1.2.9.1, 1.2.10.1, 1.2.11.1, 1.3.1.1, 1.3.2.1, 1.3.3.1, 1.3.4.1

1.2.6, 1.2.8, 1.2.9, 1.2.11, 1.2.12, 1.2.13, 1.2.14, 1.6.1, 1.6.2, 1.6.3, 1.6.4

NICE has made editorial changes to the original wording to clarify the action to be taken: a verb has been added, or the verb used has been changed.

1.2.2.1 People with suspected PD should be referred quickly4 and untreated to a specialist with expertise in the differential diagnosis of this condition.

4The Guideline Development Group considered that people with suspected mild PD should be seen within 6 weeks, but new referrals in later disease with more complex problems require an appointment within 2 weeks.

1.2.2 If Parkinson's disease is suspected, refer people quickly and untreated to a specialist with expertise in the differential diagnosis of this condition. [2006, amended 2017]

NICE has made editorial changes to the original wording to clarify the action to be taken.

In addition, the footnote referring to specific timeframes has been removed. The 2017 guideline committee noted that the 2006 recommendation was not based on evidence and should be removed.

Changes to recommendation wording for clarification only (no change to meaning)

Recommendation numbers in current guideline

Comment

All recommendations except those labelled [2017]

Recommendations have been edited into the direct style (in line with current NICE style for recommendations in guidelines) where possible.

Minor changes since publication

October 2019: A footnote was added to reflect a change in marketing authorisation status for botulinum neurotoxin type A preparations.

ISBN: 978-1-4731-2530-8

  • National Institute for Health and Care Excellence (NICE)