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[Management of levodopa-induced dyskinesia].
Rev Neurol (Paris). 2002 Dec; 158 Spec no 1:S117-24.RN

Abstract

There are three main therapeutic strategies to manage levodopa-induced dyskinesias in parkinsonian patients: (1) prevent the occurrence of the priming phenomenon which generates the abnormal movements, (2) avoid the expression of dyskinesias in already primed brain with antidyskinetic symptomatic interventions and (3) reverse, once primed, the changes that occurred in the basal ganglia to induce dyskinesias. To prevent, at least partly, priming for dyskinesias is attempted by the early use of dopamine D2 agonists, which delays the need for levodopa. To avoid the expression of dyskinesias in already primed patients, amantadine is presently the most efficacious symptomatic medication, while functional stereotactic surgery is required in the most severe cases. There are several ways to try to reverse, at least partly, dyskinesia priming. The strategy is to reduce as much as possible (ideally completely) the daily dose of levodopa, by the mean of adjunct interventions like high doses of oral agonists, or more efficiently, with apormorphine subcutaneous infusion or subthalamic deep brain stimulation.

Authors+Show Affiliations

Service de Pharmacologie, Faculté de Médecine, Centre d'Investigations Cliniques, INSERM U455, 37, Allées Jules-Guesde, 31073 Toulouse, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article
Review

Language

fre

PubMed ID

12690671

Citation

Rascol, O, et al. "[Management of Levodopa-induced Dyskinesia]." Revue Neurologique, vol. 158 Spec no 1, 2002, pp. S117-24.
Rascol O, Ferreira JJ, Payoux P, et al. [Management of levodopa-induced dyskinesia]. Rev Neurol (Paris). 2002;158 Spec no 1:S117-24.
Rascol, O., Ferreira, J. J., Payoux, P., Brefel-Courbon, C. h., & Montastruc, J. L. (2002). [Management of levodopa-induced dyskinesia]. Revue Neurologique, 158 Spec no 1, S117-24.
Rascol O, et al. [Management of Levodopa-induced Dyskinesia]. Rev Neurol (Paris). 2002;158 Spec no 1:S117-24. PubMed PMID: 12690671.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Management of levodopa-induced dyskinesia]. AU - Rascol,O, AU - Ferreira,J J, AU - Payoux,P, AU - Brefel-Courbon,Ch, AU - Montastruc,J L, PY - 2003/4/15/pubmed PY - 2003/10/31/medline PY - 2003/4/15/entrez SP - S117 EP - 24 JF - Revue neurologique JO - Rev Neurol (Paris) VL - 158 Spec no 1 N2 - There are three main therapeutic strategies to manage levodopa-induced dyskinesias in parkinsonian patients: (1) prevent the occurrence of the priming phenomenon which generates the abnormal movements, (2) avoid the expression of dyskinesias in already primed brain with antidyskinetic symptomatic interventions and (3) reverse, once primed, the changes that occurred in the basal ganglia to induce dyskinesias. To prevent, at least partly, priming for dyskinesias is attempted by the early use of dopamine D2 agonists, which delays the need for levodopa. To avoid the expression of dyskinesias in already primed patients, amantadine is presently the most efficacious symptomatic medication, while functional stereotactic surgery is required in the most severe cases. There are several ways to try to reverse, at least partly, dyskinesia priming. The strategy is to reduce as much as possible (ideally completely) the daily dose of levodopa, by the mean of adjunct interventions like high doses of oral agonists, or more efficiently, with apormorphine subcutaneous infusion or subthalamic deep brain stimulation. SN - 0035-3787 UR - https://www.unboundmedicine.com/medline/citation/12690671/[Management_of_levodopa_induced_dyskinesia]_ L2 - https://medlineplus.gov/parkinsonsdisease.html DB - PRIME DP - Unbound Medicine ER -