Dyskinesias

OLIVIER RASCOL; NELLY FABRE; CHRISTINE BREFEL-COURBON; FABIENNE ORY-MAGNE; SANTIAGO PEREZ-LLORET

The Encyclopedia of Movement Disorders.

Elsevier

Año: 2010; p. 350 - 361

Levodopa-induced dyskinesias (LIDs) are involuntary movements that occur in a majority of patients with Parkinson's disease (PD) on chronic levodopa therapy. The most frequent LIDs include chorea, stereotypies, and dystonia that can occur at various times in response to levodopa administration (peak-dose LIDs, diphasic LIDs, Off dystonia).LIDs can disable and impair health-related quality of life. LIDs result from the changes within the motor cortico-basal ganglia circuitry provoked by the nigrostriatal degeneration and pulsatile dopamine replacing treatments. Early use of dopamine agonists as initial PD treatment reduces the incidence of LIDs in comparison to levodopa therapy over the first years of treatment. Once established, LIDs can be improved by amantadine. Severe LIDs can also be managed with subcutaneous apomorphine infusions or subthalamic nucleus deep brain stimulation.