motor fluctuation

Introduction

Frequent on-off periods, freezing & dyskinesias associated with Parkinson's disease & its treatment.

Pathology

• dyskinesias usually result from peak levels of L-dopa, 1 hour after Sinemet dose, but may be biphasic

Management

• identify when symptoms occur; patient diary
• frequent low-dose Sinemet
• adjunct use of dopamine agonist
• entacapone to increase t1/2 of L-dopa
• amantadine can be helpful
• clozapine may be useful in severe cases (frequent blood monitoring)
• surgery when all else fails

More general terms

• motor dysfunction