Shale H, Tanner C
Parkinson's Institute, Sunnyvale, California, USA.
Drugs. 1996 Dec;52(6):849-60. doi: 10.2165/00003495-199652060-00006.
Dyskinesias are abnormal involuntary movements characterised by an excessive amount of movement. Typically, these movements are choreiform in nature. They may be caused by systemic, metabolic, endocrinologic, structural, vascular, infectious or inherited degenerative conditions, or be toxin- or drug-induced. With many non-drug-induced dyskinesias, treatment of the underlying condition may be sufficient to eliminate the movements, although temporary treatment may be required to control the movements if they are severe. Drug-induced dyskinesias often resolve when the offending drug is discontinued. A notable exception is tardive dyskinesia, which is caused by exposure to dopamine receptor blocking drugs, the majority of which are antipsychotic agents. Tardive dyskinesias will persist, or may even develop after the causative agent has been stopped and may not spontaneously remit. Another commonly encountered form of drug-induced dyskinesia is seen in patients with Parkinson's disease who are receiving levodopa. Medications which deplete dopamine are most successful in treating choreiform dyskinesias, although anticholinergics, GABAergics, serotonergics, and calcium channel blocking agents have been reportedly beneficial in some cases. Treatment of levodopa-induced dyskinesias requires manipulation of the patient's antiparkinsonian drug regimen.
运动障碍是一种异常的不自主运动，其特征是运动过多。通常，这些运动本质上是舞蹈样的。它们可能由全身性、代谢性、内分泌性、结构性、血管性、感染性或遗传性退行性疾病引起，或由毒素或药物诱发。对于许多非药物诱发的运动障碍，治疗潜在疾病可能足以消除这些运动，不过如果症状严重，可能需要临时治疗来控制运动。药物诱发的运动障碍通常在停用致病药物后缓解。一个显著的例外是迟发性运动障碍，它是由接触多巴胺受体阻断药物引起的，其中大多数是抗精神病药物。迟发性运动障碍会持续存在，甚至可能在致病药物停用后出现，且可能不会自发缓解。另一种常见的药物诱发运动障碍形式见于正在接受左旋多巴治疗的帕金森病患者。消耗多巴胺的药物在治疗舞蹈样运动障碍方面最为有效，尽管据报道抗胆碱能药物、γ-氨基丁酸能药物、5-羟色胺能药物和钙通道阻滞剂在某些情况下也有益处。治疗左旋多巴诱发的运动障碍需要调整患者的抗帕金森病药物治疗方案。
