Morton & Gloria Shulman Movement Disorders Center, and Division of Neurology, University of Toronto, Toronto Western Hospital, 399, Bathurst Street, Toronto, Ontario, Canada M5V 2S8.
Int Rev Neurobiol. 2011;98:31-54. doi: 10.1016/B978-0-12-381328-2.00002-X.
Levodopa-induced dyskinesia (LID) has been recognized since the introduction of levodopa for the management of Parkinson's disease (PD) and continues to be one of the most clinically challenging factors in long-term management of patients with PD. Most patients develop LID within 10 years of PD onset and the cause has been attributed to various factors including disease demographics, pharmacological, and possibly genetic causes. The clinical pattern of LID varies and shows intra and inter-patient variability and has been classified based upon phenomenology and relation to timing of levodopa. The potential armamentarium to address and manage LID has significantly increased in the last decade. This chapter addresses the current understanding of various clinical aspects and available therapeutics for LID.
左旋多巴诱导的运动障碍(LID)自左旋多巴用于治疗帕金森病(PD)以来就已被认识到,并且仍然是 PD 患者长期管理中最具临床挑战性的因素之一。大多数患者在 PD 发病后 10 年内出现 LID,其病因可归因于多种因素,包括疾病人口统计学、药理学和可能的遗传原因。LID 的临床模式多种多样,表现出个体内和个体间的变异性,并根据现象学和与左旋多巴时间的关系进行分类。在过去十年中,解决和管理 LID 的手段有了显著增加。本章介绍了对 LID 的各种临床方面和现有治疗方法的最新理解。