Medical Management and Prevention of Motor Complications in Parkinson's Disease
- PMID: 32761324
- PMCID: PMC7851275
- DOI: 10.1007/s13311-020-00889-4
Medical Management and Prevention of Motor Complications in Parkinson's Disease
Abstract
Levodopa is the most effective medication for the treatment of the motor symptoms of Parkinson's disease. However, over time, the clinical response to levodopa becomes complicated by a reduction in the duration and reliability of motor improvement (motor fluctuations) and the emergence of involuntary movements (levodopa-induced dyskinesia). Strategies that have been attempted in an effort to delay the development of these motor complications include levodopa sparing and continuous dopaminergic therapy. Once motor complications occur, a wide array of medical treatments is available to maximize motor function through the day while limiting dyskinesia. Here, we review the clinical features, epidemiology, and risk factors for the development of motor complications, as well as strategies for their prevention and medical management.
Keywords: Parkinson’s disease; continuous dopaminergic stimulation; levodopa; levodopa-induced dyskinesia; motor fluctuations; treatment.
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References
-
- Postuma RB, Berg D, Stern M, et al. MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord. 2015;30:1591–1601. - PubMed
-
- Chou KL, Stacy M, Simuni T, Miyasaki J, Oertel WH, Sethi K, Fernandez HH, Stocchi F. The spectrum of “off” in Parkinson’s disease: What have we learned over 40 years? Parkinsonism Relat Disord. 2018;51:9–16. - PubMed
-
- Jankovic J. Motor fluctuations and dyskinesias in Parkinson’s disease: clinical manifestations. Mov Disord. 2005;20(Suppl 11):S11–6. - PubMed
-
- Hauser RA, Friedlander J, Zesiewicz TA, Adler CH, Seeberger LC, O’Brien CF, Molho ES, Factor SA. A home diary to assess functional status in patients with Parkinson’s disease with motor fluctuations and dyskinesia. Clin Neuropharmacol. 2000;23:75–81. - PubMed
-
- Aquino CC, Fox SH. Clinical spectrum of levodopa-induced complications. Mov Disord. 2015;30:80–89. - PubMed
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