Stocchi F, Nordera G, Marsden C D
Mediterranean Institute of Neuroscience, Pozzilli, Italy.
Clin Neuropharmacol. 1997 Apr;20(2):95-115. doi: 10.1097/00002826-199704000-00001.
Patients with advanced Parkinson's disease often develop severe fluctuations and dyskinesias while receiving long-term levodopa therapy. These complications can prove increasingly difficult to control. Here we review our strategies for coping with such problems. These include establishing the best rational schedule of levodopa treatment, optimizing levodopa absorption, the use of oral dopaminergic agonists, and the use of subcutaneous injections or infusions of apomorphine or lisuride. The problems of severe dyskinesias, sleep disturbances, psychotoxicity, and urinary difficulties also are considered. Finally, the role of new surgical procedures to treat Parkinson's disease is reviewed.
晚期帕金森病患者在接受长期左旋多巴治疗时常常会出现严重的症状波动和异动症。这些并发症会越来越难以控制。在此，我们回顾应对此类问题的策略。这些策略包括制定最佳的左旋多巴合理治疗方案、优化左旋多巴吸收、使用口服多巴胺能激动剂，以及皮下注射或输注阿扑吗啡或利苏瑞肽。还会考虑严重异动症、睡眠障碍、精神毒性和排尿困难等问题。最后，会回顾治疗帕金森病的新手术方法的作用。
