Defebvre Luc
Clinique Neurologique, Service de Neurologie et Pathologie du Mouvement, EA2683, Hôpital R. Salengro, CHU, 59037 Lille, France.
Therapie. 2004 Jan-Feb;59(1):93-6. doi: 10.2515/therapie:2004019.
The aim of this study was to present the clinical characteristics of and the evaluation methods for the motor complications sometimes observed in the early stages of Parkinson's disease, differentiating motor fluctuations and levodopa-induced dyskinesias. The most common forms of motor fluctuations are the predictable end-of-dose deterioration (wearing off), the early-morning akinesia, and the on-off phenomenon. Non-motor fluctuations are often associated with different symptoms: dysautonomia, pain, psychic or cognitive signs during off periods and sometimes also during on periods. Levodopa-induced dyskinesias are classified according to their temporal profile after drug administration, namely peak-dose dyskinesias (mainly choreic movements), biphasic dyskinesias--onset and end-of-dose--(mainly dystonic and ballic movements), and finally off-period dyskinesias (dystonic movements). Clinical evaluation of motor complications must be performed precisely to establish the best therapeutic strategy.
本研究的目的是介绍帕金森病早期有时观察到的运动并发症的临床特征及评估方法,区分运动波动和左旋多巴诱导的异动症。运动波动最常见的形式是可预测的剂末恶化(疗效减退)、清晨运动不能和开关现象。非运动波动常伴有不同症状:自主神经功能障碍、疼痛、关期以及有时开期的精神或认知症状。左旋多巴诱导的异动症根据给药后的时间特征进行分类,即峰剂量异动症(主要为舞蹈样动作)、双相异动症——剂初和剂末——(主要为肌张力障碍和投掷样动作),以及最后关期异动症(肌张力障碍动作)。必须精确进行运动并发症的临床评估以制定最佳治疗策略。