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Levodopa‐induced dyskinesias in Parkinson's disease: Clinical and pharmacological classification

 

作者: M. R. Luquin,   O. Scipioni,   J. Vaamonde,   O. Gershanik,   José A. Obeso,  

 

期刊: Movement Disorders  (WILEY Available online 1992)
卷期: Volume 7, issue 2  

页码: 117-124

 

ISSN:0885-3185

 

年代: 1992

 

DOI:10.1002/mds.870070204

 

出版商: Wiley Subscription Services, Inc., A Wiley Company

 

关键词: L–dopa‐induced dyskinesias;Parkinson's disease

 

数据来源: WILEY

 

摘要:

AbstractLevodopa‐induced dyskinesias (LID) in Parkinson's disease (PD) may be classified into three main categories: “On” dyskinesias, diphasic dyskinesias (DD), and “off” periods. The study of 168 parkinsonian patients showed that about half (n = 84) showed one pattern of LID only. A combination of two was present in 68, and 16 had the three presentation patterns. A fairly good correlation between type of dyskinesia and presentation pattern was established. Chorea, myoclonus, and dystonic movements occurred during the “on” period. Dystonic postures, particularly affecting the feet, were mainly present in the “off” period, but a few patients had a diphasic presentation. Repetitive stereotyped movements of the lower limbs always corresponded to DD. Acute pharmacological tests using dopamine agonists 9subcutaneous apomorphine 3–8 mg; intravenous lisuride 0. (1–0. 15 mg) and dopamine antagonists (intravenous sulpiride 200–400 mg and intravenous chlorpromazine 25 mg) were performed in 40 patients. Dopamine agonists enhanced “on” dyskinesias and markedly reduced or abolished “off” period dystonia and DD. Dopamine antagonists reduced all types of LID but usually aggravated parkinsonism. These clinical and pharmacological results indicate that LID in PD are a heterogeneous phenomenon difficult to explain on the basis of a sing

 

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