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Levodopa-induced-dyskinesias clinical features, incidence, risk factors, management and impact on quality of life.
J Parkinsons Dis. 2012; 2(3):189-98.JP

Abstract

Levodopa-induced dyskinesias (LID) belong to the most common dose-limiting adverse effects of levodopa therapy. "Peak-dose" LID occur with the maximum effect of medication, 'diphasic dyskinesias' have a "beginning- and end-of-dose" pattern, and the, "off-period dyskinesia" occur during off-periods, most frequently in the early mornings and are typically dystonic in nature. The majority of patients will have developed dyskinesias after 10 years of treatment, and about 40-50% after 5 years. Occurrence of LID appears to be related to dose and duration of treatment with levodopa and severity and duration of disease. In addition, patients with younger age of onset have been reported to have an earlier onset and higher rate of LID. The important aetiological role of non-physiological pulsatile stimulation of dopaminergic receptors is increasingly recognized and more continuous dopaminergic stimulation with the longer acting dopamine agonists has been shown to reduce and delay the onset of dyskinesias. LID may not have a significant effect on quality of life in patients with early disease or in very advanced disease stages. when often other problems arise, but in other patients they may be severely disabling. Treatment strategies to overcome LID include adjustment of timing, type and amount of dopaminergic medication, treatment with amantadine and, in treatment resistant cases, stereotactic surgery involving deep brain stimulation or lesioning procedures. A number of other pharmacological options are also being explored. Several methods for the assessment of LID are available to attempt accurate assessment of efficacy, although all of these have limitations, and further evidence on their utility if needed.

Authors+Show Affiliations

Wessex Neurological Centre, Southampton General Hospital, Southampton, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23938226

Citation

Manson, Alice, et al. "Levodopa-induced-dyskinesias Clinical Features, Incidence, Risk Factors, Management and Impact On Quality of Life." Journal of Parkinson's Disease, vol. 2, no. 3, 2012, pp. 189-98.
Manson A, Stirpe P, Schrag A. Levodopa-induced-dyskinesias clinical features, incidence, risk factors, management and impact on quality of life. J Parkinsons Dis. 2012;2(3):189-98.
Manson, A., Stirpe, P., & Schrag, A. (2012). Levodopa-induced-dyskinesias clinical features, incidence, risk factors, management and impact on quality of life. Journal of Parkinson's Disease, 2(3), 189-98. https://doi.org/10.3233/JPD-2012-120103
Manson A, Stirpe P, Schrag A. Levodopa-induced-dyskinesias Clinical Features, Incidence, Risk Factors, Management and Impact On Quality of Life. J Parkinsons Dis. 2012;2(3):189-98. PubMed PMID: 23938226.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Levodopa-induced-dyskinesias clinical features, incidence, risk factors, management and impact on quality of life. AU - Manson,Alice, AU - Stirpe,Paola, AU - Schrag,Anette, PY - 2013/8/14/entrez PY - 2012/1/1/pubmed PY - 2014/6/21/medline SP - 189 EP - 98 JF - Journal of Parkinson's disease JO - J Parkinsons Dis VL - 2 IS - 3 N2 - Levodopa-induced dyskinesias (LID) belong to the most common dose-limiting adverse effects of levodopa therapy. "Peak-dose" LID occur with the maximum effect of medication, 'diphasic dyskinesias' have a "beginning- and end-of-dose" pattern, and the, "off-period dyskinesia" occur during off-periods, most frequently in the early mornings and are typically dystonic in nature. The majority of patients will have developed dyskinesias after 10 years of treatment, and about 40-50% after 5 years. Occurrence of LID appears to be related to dose and duration of treatment with levodopa and severity and duration of disease. In addition, patients with younger age of onset have been reported to have an earlier onset and higher rate of LID. The important aetiological role of non-physiological pulsatile stimulation of dopaminergic receptors is increasingly recognized and more continuous dopaminergic stimulation with the longer acting dopamine agonists has been shown to reduce and delay the onset of dyskinesias. LID may not have a significant effect on quality of life in patients with early disease or in very advanced disease stages. when often other problems arise, but in other patients they may be severely disabling. Treatment strategies to overcome LID include adjustment of timing, type and amount of dopaminergic medication, treatment with amantadine and, in treatment resistant cases, stereotactic surgery involving deep brain stimulation or lesioning procedures. A number of other pharmacological options are also being explored. Several methods for the assessment of LID are available to attempt accurate assessment of efficacy, although all of these have limitations, and further evidence on their utility if needed. SN - 1877-718X UR - https://www.unboundmedicine.com/medline/citation/23938226/Levodopa_induced_dyskinesias_clinical_features_incidence_risk_factors_management_and_impact_on_quality_of_life_ L2 - https://content.iospress.com/openurl?genre=article&id=doi:10.3233/JPD-2012-120103 DB - PRIME DP - Unbound Medicine ER -