Lang A E, Meadows J C, Parkes J D, Marsden C D
J Neurol Neurosurg Psychiatry. 1982 Sep;45(9):823-5. doi: 10.1136/jnnp.45.9.823.
Many patients with idiopathic Parkinson's disease treated with levodopa for more than five years develop fluctuations in their clinical response to this drug. Such fluctuations may be unpredictable, but more commonly occur in a regular pattern related to the size and timing of the levodopa dosage. Theories as to their cause have emphasised both the progression of the underlying Parkinson's disease and the possibility of a late side-effect of levodopa. We report two children with Parkinsonism, one after recurrent obstructive hydrocephalus and the other following an encephalitic illness. Both patients had striking improvement with levodopa, but developed predictable and unpredictable dramatic response fluctuations within weeks of starting levodopa therapy. This suggests that neither the pathology of idiopathic Parkinson's disease, nor the long-term use of levodopa are essential for the development of predictable or unpredictable fluctuations in response to levodopa therapy.
许多接受左旋多巴治疗超过五年的特发性帕金森病患者，其对该药物的临床反应会出现波动。这种波动可能无法预测，但更常见的是按照与左旋多巴剂量大小和给药时间相关的规律模式出现。关于其病因的理论既强调了潜在帕金森病的进展，也强调了左旋多巴后期副作用的可能性。我们报告了两名患有帕金森症的儿童，一名是在复发性梗阻性脑积水后患病，另一名是在患脑炎后患病。两名患者使用左旋多巴后均有显著改善，但在开始左旋多巴治疗后的几周内出现了可预测和不可预测的剧烈反应波动。这表明，对于左旋多巴治疗反应出现可预测或不可预测的波动，特发性帕金森病的病理以及左旋多巴的长期使用都不是必需的。
