Is the motor complications in Parkinson's disease are due to early use of L-Dopa or due to progression of the disease
Extended use of levodopa can result in the patient experiencing dyskinesia (involuntary movements) and motor fluctuations (where the patient experiences “off-time” periods, as the drug, wears off and symptoms re-emerge).
Also, Parkinson diseases are progressive diseases
Dear Aqeel K. Hatem ,
nowadays neurologists tend to start the pharmacological therapy as soon as possible since it has been demonstrated that an early drug administration helps to slow down the disease progression.
That has been said, Parkinson's disease (PD) progression is quite heterogeneous among patients, thus each patient may experience a different path with different motor symptoms at different timings.
In general, L-Dopa mitigates some of the PD motor complications, such as bradykinesia (i.e. slowness of movement) and freezing of gait (i.e. a sudden motor block), while may cause other complications such as dyskinesia (i.e. involuntary movements) as the disease progresses.
When the effect of L-Dopa become limited and/or motor complications associated with L-Dopa administration become severe, other treatments may be used instead (e.g. deep brain stimulation, Duodopa)
After an initial period of dramatic benefit of levodopa, several limitations become apparent including, “dopa resistant” motor symptoms (postural abnormalities, freezing episodes, speech impairment), “dopa resistant” non-motor signs (autonomic dysfunction, mood, and cognitive impairment, etc), and/or drug-related side effects (especially psychosis, motor fluctuations, and dyskinesias). Motor complications include fluctuations, dyskinesias, and dystonia. Kindly check the following link:
https://pmj.bmj.com/content/80/946/452
Hi Dr Aqeel K. Hatem . I hope the following link could help: Article Motor Complications of Dopaminergic Medications in Parkinson's Disease
Hi Dt Aqeel K. Hatem . I hope the following link could help: https://www.ncbi.nlm.nih.gov/books/NBK482140/
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