Lhermitte F, Agid Y, Signoret J L, Studler J M
Rev Neurol (Paris). 1977 May;133(5):297-308.
The four cases of dyskinesia at the "beginning and end of dose" caused by L-Dopa presented in this series were characterized by four essential features: 1) their onset at the beginning and end of the period of effectiveness of a dose of L-Dopa + IDC (benserazide); 2) their ballic and dystonic appearance associated with a reinforcement of Parkinsonian signs; 3) the possibility of their reduction by an increase and fractionning of the daily dose of L-Dopa; 4) the particular nature of the underlying Parkinsonian problem in which they were seen, i.e. the young age at onset of the disease, the severity of akinesia, and the quality of the clinical response to L-Dopa. Thus on the basis of the circumstances of their development, their appearance, and their treatment, such forms of dyskinesia at the "beginning and end of dose" appear to be different from classical "mid-dose" dyskinesia. In addition, they pose a new physiolopathological problem.
本系列中所呈现的由左旋多巴导致的4例“剂量开始和结束时”运动障碍具有四个基本特征：1）它们在一剂左旋多巴+IDC（苄丝肼）疗效期开始和结束时出现；2）它们呈舞蹈样和张力障碍样外观，伴有帕金森体征加重；3）通过增加左旋多巴日剂量并分多次服用，它们有可能减轻；4）出现这些运动障碍的潜在帕金森病问题的特殊性质，即疾病起病时年龄较轻、运动不能的严重程度以及对左旋多巴的临床反应质量。因此，基于其发生情况、表现及治疗，这种“剂量开始和结束时”的运动障碍形式似乎不同于经典的“剂量中期”运动障碍。此外，它们还带来了一个新的生理病理学问题。
