Journal
JOURNAL OF THE NEUROLOGICAL SCIENCES
Volume 289, Issue 1-2, Pages 89-92Publisher
ELSEVIER
DOI: 10.1016/j.jns.2009.08.022
Keywords
Parkinson's disease; Nonmotor fluctuations; On-off periods
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The majority of patients with Parkinson's disease (PD) on levodopa (LD) treatment Usually experience motor fluctuations (MFs) within several years of initiation of treatment. Besides the classic MFs, many nonmotor fluctuations (NMFs) may occur in PD NMFs appear both in the on state and off state However, the clinical spectrum and the frequency of these symptoms are not well recognized NMFs are usually mild and less disabling than MFs but sometimes can lead to unnecessary tests and therapies. NMFs occurring in association with the on state are better known and therefore more frequently diagnosed than those occurring in the off state. NMFs can be classified into three groups autonomic. cognitive/psychiatric, and sensory They include gastrointestinal and urinary symptoms, drenching sweats, temperature and blood-pressure changes, depression, anxiety, hallucinations, hypomania, moaning/screaming, confusion, cognitive dysfunction, sexual deviations and dopamine dysregulation syndrome (DDS), pain, akathisia, internal tremor, numbness/parasthesia, and dyspnea Conclusion Recognition of NMFs may prevent unnecessary diagnostic tests and may lead to treatment modifications aimed to minimize their occurrence Crown Copyright (C) 2009 Published by Elsevier B V All rights reserved
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