Vaamonde Gamo J, Cabello J P, Gallardo Alcañiz M J, Flores Barragan J M, Carrasco García de León S, Ibañez Alonso R E
Servicio de Neurología, Hospital General de Ciudad Real, Ciudad Real, España.
Neurologia. 2010 Jan-Feb;25(1):27-31.
Freezing of gait unresponsive to dopaminergic stimulation in patients with severe Parkinsonism. The freezing of gait episodes (FOG) normally appear during the off period and generally improve with dopaminergic stimulus, at the same time as improving other Parkinsonian symptoms.
We report a group of 10 patients with severe Parkinson's disease. All patients suffered motor fluctuations, dyskinesias and episodes of FOG during the on and off state. The patients received a subcutaneous apomorphine bolus, without other dopaminergic medication; an effective dose of apomorphine was considered as one that induced a reduction of at least a 60% in the UPDRS motor scale.
The baseline motor UPDRS was 61.3 +/- 4.7, which dropped to 21 +/- 4.3 after the apomorphine injection. The mean dose of apomorphine was 5.5 mg (3-7 mg). The bolus of apomorphine improved the parameters of the gait related to bradykinesia and the tapping tests of the limbs, but the episodes of FOG did not vary significantly between the off and on state.
We present a group of 10 patients with freezing of gait episodes that did not improve with treatment and persisted during the on period induced by dopaminergic stimulus with apomorphine.
重度帕金森病患者中对多巴胺能刺激无反应的步态冻结。步态冻结发作（FOG）通常出现在“关”期，一般随着多巴胺能刺激而改善，同时其他帕金森症状也会改善。
我们报告一组10例重度帕金森病患者。所有患者在“开”期和“关”期均出现运动波动、异动症和FOG发作。患者接受皮下注射阿扑吗啡推注，未使用其他多巴胺能药物；有效剂量的阿扑吗啡被认为是能使统一帕金森病评定量表（UPDRS）运动评分至少降低60%的剂量。
基线运动UPDRS为61.3±4.7，注射阿扑吗啡后降至21±4.3。阿扑吗啡的平均剂量为5.5毫克（3 - 7毫克）。阿扑吗啡推注改善了与运动迟缓相关的步态参数以及肢体的轻敲试验，但FOG发作在“关”期和“开”期之间无显著差异。
我们报告了一组10例步态冻结发作患者，其发作并未因阿扑吗啡多巴胺能刺激诱导的“开”期治疗而改善且持续存在。
