title: [Fluctuations and dyskinesias as early L-dopa-induced motor complications in severe Parkinsonian's patients].
abstract: Daily fluctuations of motor performance and dyskinesias in patients with Parkinson's disease (PD) treated with levodopa represent a difficult challenge to our understanding. We report 10 patients diagnosed of severe PD (Hoehn and Yahr: III-IV/V) treated with levodopa (range of dose: 750-900 mg/day) in single drug therapy since their diagnosis (mean time of levodopatherapy: 4.8 2.4 months, range: 3-6 months). All patients developed motor complications within weeks to months after initiating L-dopatherapy. Two patients received an intravenous apomorphine infusion (mean dose: 8.5 mg/day) during a mean time of 7.5 hours, but motor complications persisted during the infusion in spite of continuous dopaminergic stimulus. The degree of nigrostriatal damage (disease severity) seems to be a very important risk factor for the development of treatment-related motor complications.
authors.affiliation: Servicio de Neurología, Complejo Hospitalario de Ciudad Real, Spain. jvaamonde@hnsa.insalud.es
authors.forename: J
authors.initials: J
authors.lastname: Vaamonde
authors.forename: R
authors.initials: R
authors.lastname: Ibáñez
authors.forename: M
authors.initials: M
authors.lastname: Gudín
authors.forename: A
authors.initials: A
authors.lastname: Hernández
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001058:Apomorphine / Q000627:therapeutic use; D018491:Dopamine Agonists / Q000627:therapeutic use; D004409:Dyskinesia, Drug-Induced / Q000209:etiology*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D012307:Risk Factors
chemical_list: D000978:Antiparkinson Agents; D018491:Dopamine Agonists; D007980:Levodopa; D001058:Apomorphine