Motor fluctuations and dyskinesias in Parkinson's disease: clinical manifestations
Motor fluctuations and dyskinesias in Parkinson's disease: clinical manifestations
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DOI：
10.1002/mds.20458
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发表时间：
2005-04-01
影响因子：
8.6
通讯作者：
Jankovic, J
中科院分区：
文献类型：
--
作者：
Jankovic, J
帕金森病（PD）症状的波动，例如磨损和开关效应以及运动障碍，与多种因素有关，包括左旋多巴的持续时间和剂量、发病年龄、压力、睡眠、食物摄入量以及其他药代动力学和药效学机制。大多数患者，特别是那些年轻发病的PD患者，在治疗几年后会出现这些左旋多巴相关的不良反应。这些运动并发症的评估是困难的，因为显着的临床变异性之间和患者内。每日日记已被用于临床试验，旨在评估各种药物和手术干预对运动波动和运动障碍的影响。最常见的运动障碍类型，称为“峰值剂量运动障碍”，通常由涉及头部、躯干和四肢的刻板舞蹈或弹道运动组成，偶尔也涉及呼吸肌，而震颤和踩踏是不太常见的并发症。肌张力障碍通常也出现在双相运动障碍和磨损效应的患者中。认识左旋多巴相关运动并发症的临床现象学的全谱对于其治疗和预防至关重要。(c)2005年，任上海市人民政府副市长。
Fluctuations in the symptoms of Parkinson's disease (PD), such as wearing-off and on-off effects, and dyskinesias are related to a variety of factors, including duration and dosage of levodopa, age at onset, stress, sleep, food intake, and other pharmacokinetic and pharmacodynamic mechanisms. The majority of patients, particularly those with young onset of PD, experience these levodopa-related adverse effects after a few years of treatment. Assessment of these motor complications is difficult because of the marked clinical variability between and within patients. Daily diaries have been used in clinical trials designed to assess the effects of various pharmacological and surgical interventions on motor fluctuations and dyskinesias. The most common type of dyskinesia, called "peak-dose dyskinesia", usually consists of stereotypical choreic or ballistic movements involving the head, trunk, and limbs, and occasionally, the respiratory muscles, whereas tremor and punding are less-common complications. Dystonia is also typically seen in patients with diphasic dyskinesia and wearing-off effect. Recognition of the full spectrum of clinical phenomenology of levodopa-related motor complications is essential for their treatment and prevention. (c) 2005 Movement Disorder Society.