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Motor Complications of Chronic Levodopa Therapy in Parkinson's Disease

 

作者: Edison Miyawaki,   Kelly Lyons,   Rajesh Pahwa,   Alexander Tröster,   Jean Hubble,   Diane Smith,   Karen Busenbark,   Desni McGuire,   Debra Michalek,   William Koller,  

 

期刊: Clinical Neuropharmacology  (OVID Available online 1997)
卷期: Volume 20, issue 6  

页码: 523-530

 

ISSN:0362-5664

 

年代: 1997

 

出版商: OVID

 

关键词: Motor fluctuations;Levodopa-induced dyskinesia.

 

数据来源: OVID

 

摘要:

We report on motor complications of chronic levodopa therapy among 811 levodoparesponsive patients with idiopathic Parkinson's disease (PD), stratified by duration after diagnosis. Predictable “offs” were noted in 20.2% of patients in the first 5 years, in 58.3% after 15 years. Unpredictable or sudden offs and early morning dystonia were less common. Longer duration was associated with greater percentages of patients with off periods or dyskinesias (up to 70% after 15 years), although patients with 6–15 years' duration saw relatively little increase in frequency of those complications, and a minority of patients (∼30%) with duration into the second decade did not experience off periods or dyskinesia. Across groups, mean Hoehn and Yahr stage and daily levodopa dosage progressively increase (and mean Schwab and England disability ratings decrease), but more conservatively than in prior reports in the postlevodopa era. We note that with advancing PD duration, levodopa complications are more common, but in many cases there appear to be relatively stable periods in terms of levodopa dosage and disease severity, and a minority of patients will be relatively free of motor complications into the second decade of their disease.

 

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