We describe the familial variants PNP. Syndrome, similar to ANP, may be a manifestation of the disease and encephalopathy distsirkulyatornoy Whipple. The appearance of similar symptoms in young people requires a differential diagnosis of hepatolenticular degeneration and disease Niemann - Pick from the permanent Eldepryl 5mg. The presence of cerebellar ataxia, peripheral motor neurons signs of injury or polyneuropathy, severe autonomic failure, aphasia or focal sensitivity disorders, disease onset before the age of 40 years, and its slow progression exclude the diagnosis of PNP.

Treatment.

In most cases the effect of the drugs Selegiline is absent or transient. However, to draw conclusions about the ineffectiveness of generic Eldepryl should be only after the drug is tried in the high dose (1000-1500 mg Selegiline in combination with an inhibitor of DOPA decarboxylase), but if it is ineffective, then gradually reduce it. Sometimes it gives temporary effect of the drug combination of levodopa and dopamine agonists. Anticholinergics are ineffective and may exacerbate cognitive impairment. In some cases, some effect can be obtained by using low doses of amitriptyline and amantadine. Some studies have shown the effectiveness of serotonergic (selective serotonin reuptake inhibitors such as fluoxetine, or antiserotoninovym medications such as methysergide), as well as tools that affect noradrenergic transmission (idazoxan, yohimbine) and central cholinomimetics (donepezil).