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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