Following the diagnosis of Parkinson's disease, treatment may be initiated with MAO-B-inhibitor, even prior to the development of any functional deficit. For patients with a functional deficit who are younger (usually under 75 years of age) and otherwise in good condition, treatment should be started with a dopamine agonist or MAO-B-inhibitor. In other patients, initial treatment with levodopa is recommended. In the case of difficult on-off-symptoms and dyskinesias in spite of optimal treatment, surgical procedures and duodenal levodopa infusion should be considered. Rehabilitation should be targeted at specific problems associated with functional skills.