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Parkinson’s Disease: Levodopa-Induced Dyskinesia

  • Roongroj Bhidayasiri
  • Daniel Tarsy
Chapter
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Part of the Current Clinical Neurology book series (CCNEU)

Abstract

Although very effective, chronic levodopa therapy for Parkinson’s disease (PD) is frequently complicated by the subsequent development of motor complications, which take the form of fluctuations of bradykinesia, rigidity, and tremor- and levodopa-induced dyskinesia and dystonia. With each year of levodopa treatment, about 10% of patients develop motor complications. Young age of PD onset, disease duration and severity, and high doses of levodopa are recognized risk factors for the appearance of motor complications. These complications continue to be a source of disability for PD patients and are a major limiting factor in the therapeutic efficacy of levodopa.

Keywords

Involuntary Movement Motor Complication Levodopa Treatment Bicycle Movement Levodopa Dose 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

5 PD - Levodopa-induced dyskesia.mp4 (MP4 30,822KB)

The patient shows choreiform movements involving the entire body, more prominently in the legs, hands, trunk, and neck. She could not suppress these movements. Examination revealed impaired balance together with cervical and upper extremity dyskinesia and dystonic posturing. Tremor and rigidity are minimal during the period of dyskinesia.

References

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    Bhidayasiri R, Truong DD. Motor complications in Parkinson disease: clinical manifestations and management. J Neurol Sci. 2008;266:204–15.PubMedCrossRefGoogle Scholar
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    Calabresi P, Di Filippo M, Ghiglieri V, et al. Levodopa-induced dyskinesias in patients with Parkinson’s disease: filling the bench-to-bedside gap. Lancet Neurol. 2010;9:1106–17.PubMedCrossRefGoogle Scholar
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    Nutt JG. Levodopa-induced dyskinesia: review, observations, and speculations. Neurology. 1990;40:340–5.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Roongroj Bhidayasiri
    • 1
    • 2
  • Daniel Tarsy
    • 3
  1. 1.Chulalongkorn Center of Excellence on Parkinson’s Disease and Related DisordersChulalongkorn University HospitalBangkokThailand
  2. 2.Department of NeurologyDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Department of NeurologyHarvard Medical School Beth Israel Deaconess Medical CenterBostonUSA

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