LEVODOPA-INDUCED DYSKINESIAS IN PARKINSONS-DISEASE - CLINICAL AND PHARMACOLOGICAL CLASSIFICATION

被引：193

作者：

LUQUIN, MR

SCIPIONI, O

VAAMONDE, J

GERSHANIK, O

OBESO, JA

机构：

[1] UNIV NAVARRA,CLIN UNIV,DEPT NEUROL,MOVEMENT DISORDERS UNIT,APARTADO 192,E-31080 PAMPLONA,SPAIN

[2] HOSP FRANCES RIOSA,DEPT NEUROL,EXTRAPYRAMIDAL DIS SECT,BUENOS AIRES,ARGENTINA

来源：

MOVEMENT DISORDERS | 1992年 / 7卷 / 02期

关键词：

L; DOPA-INDUCED DYSKINESIAS; PARKINSONS DISEASE;

D O I：

10.1002/mds.870070204

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Levodopa-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 (subcutaneous 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 single pathophysiological mechanism.

引用

页码：117 / 124

页数：8

共 29 条

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