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Levodopa-induced dyskinesia: clinical features, incidence, and risk factors.
J Neural Transm (Vienna). 2018 08; 125(8):1109-1117.JN

Abstract

Symptoms of Parkinson's disease have been controlled with levodopa for many years; however, motor complications consisting of wearing off of medication effect and dyskinesias tend to occur within a few years of starting levodopa. Motor complications can begin a few months after taking levodopa, with the average time to onset estimated to be 6.5 years. Dyskinesias can be troublesome and require intervention. Levodopa-induced dyskinesia can be composed of a variety of movement disorders including chorea, dystonia, ballism, myoclonus, and akathisia. Based on the clinical pattern, the most common dyskinesia is chorea and choreoathetosis. The clinical manifestations can be divided into three main categories based on their clinical movement patterns and the temporal correlation between the occurrence of dyskinesia and the levodopa dosing: on or peak-dose dyskinesias, biphasic dyskinesias, and Off dyskinesias. Severe cases of dyskinesia have been reported, with the extreme being dyskinesia-hyperpyrexia syndrome. The prevalence of LID has been reported in many studies, but the reported incidence varies. The rate of LID development is from 3 to 94%. The prevalence of LID mainly depends on age at onset, disease duration, and severity, and duration of levodopa therapy. Some of the risk factors for the development of dyskinesia are modifiable. Modifiable risk factors include levodopa dose and body weight. Non-modifiable risk factors include age, gender, duration of disease, clinical subtype, disease progression, disease severity, and genetic factors.

Authors+Show Affiliations

Neurology Department, University Medical Center, Ho Chi Minh City, Vietnam.Neurology Department, International Neurosurgery Hospital, Ho Chi Minh City, Vietnam.Loma Linda University, Loma Linda, CA, 92354, USA.The Truong Neuroscience Institute, Orange Coast Memorial Medical Center, Fountain Valley, CA, 92708, USA. dtruong@pmdi.org. Department of Psychiatry and Neuroscience, UC Riverside, Riverside, CA, USA. dtruong@pmdi.org.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29971495

Citation

Tran, Tai N., et al. "Levodopa-induced Dyskinesia: Clinical Features, Incidence, and Risk Factors." Journal of Neural Transmission (Vienna, Austria : 1996), vol. 125, no. 8, 2018, pp. 1109-1117.
Tran TN, Vo TNN, Frei K, et al. Levodopa-induced dyskinesia: clinical features, incidence, and risk factors. J Neural Transm (Vienna). 2018;125(8):1109-1117.
Tran, T. N., Vo, T. N. N., Frei, K., & Truong, D. D. (2018). Levodopa-induced dyskinesia: clinical features, incidence, and risk factors. Journal of Neural Transmission (Vienna, Austria : 1996), 125(8), 1109-1117. https://doi.org/10.1007/s00702-018-1900-6
Tran TN, et al. Levodopa-induced Dyskinesia: Clinical Features, Incidence, and Risk Factors. J Neural Transm (Vienna). 2018;125(8):1109-1117. PubMed PMID: 29971495.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Levodopa-induced dyskinesia: clinical features, incidence, and risk factors. AU - Tran,Tai N, AU - Vo,Trang N N, AU - Frei,Karen, AU - Truong,Daniel D, Y1 - 2018/07/03/ PY - 2018/03/08/received PY - 2018/06/26/accepted PY - 2018/7/5/pubmed PY - 2019/11/5/medline PY - 2018/7/5/entrez KW - Adverse effects of levodopa KW - Dyskinesia KW - Parkinson’s disease SP - 1109 EP - 1117 JF - Journal of neural transmission (Vienna, Austria : 1996) JO - J Neural Transm (Vienna) VL - 125 IS - 8 N2 - Symptoms of Parkinson's disease have been controlled with levodopa for many years; however, motor complications consisting of wearing off of medication effect and dyskinesias tend to occur within a few years of starting levodopa. Motor complications can begin a few months after taking levodopa, with the average time to onset estimated to be 6.5 years. Dyskinesias can be troublesome and require intervention. Levodopa-induced dyskinesia can be composed of a variety of movement disorders including chorea, dystonia, ballism, myoclonus, and akathisia. Based on the clinical pattern, the most common dyskinesia is chorea and choreoathetosis. The clinical manifestations can be divided into three main categories based on their clinical movement patterns and the temporal correlation between the occurrence of dyskinesia and the levodopa dosing: on or peak-dose dyskinesias, biphasic dyskinesias, and Off dyskinesias. Severe cases of dyskinesia have been reported, with the extreme being dyskinesia-hyperpyrexia syndrome. The prevalence of LID has been reported in many studies, but the reported incidence varies. The rate of LID development is from 3 to 94%. The prevalence of LID mainly depends on age at onset, disease duration, and severity, and duration of levodopa therapy. Some of the risk factors for the development of dyskinesia are modifiable. Modifiable risk factors include levodopa dose and body weight. Non-modifiable risk factors include age, gender, duration of disease, clinical subtype, disease progression, disease severity, and genetic factors. SN - 1435-1463 UR - https://www.unboundmedicine.com/medline/citation/29971495/Levodopa_induced_dyskinesia:_clinical_features_incidence_and_risk_factors_ DB - PRIME DP - Unbound Medicine ER -