Abstract
Motor fluctuations and dyskinesias are complications that invariably occur with the progression of Parkinson's disease, affecting about 90 % of patients after ten years of disease. The treatment of these conditions requires an understanding of the pattern, features and type of motor fluctuations and dyskinesias in each patient. In this chapter, the characteristics of motor complications are reviewed and the strategies and algorithms for its management are described, including the indications and recommendations of the available advanced therapies in Colombia, such as functional neurosurgery and subcutaneous apomorphine.
References
Fox SH, Lang AE. Levodopa-related motor complications-phenomenology. Mov Disord. 2008;23 Suppl 3:S509-14.
Martinez-Fernandez R, Schmitt E, Martinez-Martin P, Krack P. The hidden sister of motor fluctuations in Parkinson's disease: A review on nonmotor fluctuations. Mov Disord. 2016;31(8):1080-94.
Quinn NP. Classification of fluctuations in patients "with Parkinson's disease. Neurology. 1998;51(2 Suppl 2):S25-9.
Ahlskog JE, Muenter MD. Frequency of levodopa-related dyskinesias and motor fluctuations as estimated from the cumulative literature. Mov Disord. 2001;16(3):448-58.
Warren Olanow C, Kieburtz K, Rascol O, Poewe W Schapira AH, Emre M, et al. Factors predictive of the development of Levodopa-induced dyskinesia and wearing-off in Parkinson's disease. Mov Disord. 2013;28(8):1064-71.
Cilia R, Akpalu A, Sarfo FS, Cham M, Amboni M, Cereda E, et al. The modern pre-levodopa era of Parkinson's disease: insights into motor complications from sub-Saharan Africa. Brain. 2014;137(Pt 10):2731-42.
Schapira AH V, Emre M, Jenner P, Poewe W Levodopa in the treatment of Parkinson's disease. Eur J Neurol. 2009;16(9):982-9.
Obeso JA, Rodriguez-Oroz MC, Chana P, Lera G, Rodriguez M, Olanow CW. The evolution and origin of motor complications in Parkinson's disease. Neurology. 2000;55(11 Suppl 4):S13-20; discussion S21-3.
Grace AA. Physiology of the normal and dopamine-depleted basal ganglia: insights into levodopa pharmacotherapy. Mov Disord. 2008;23 (Suppl 3):S560-9.
Aquino CC, Fox SH. Clinical spectrum of levodopa-induced complications. Mov Disord. 2015;30(1):80-9.
Lee WY, Yoon WT, Shin HY, Jeon SH, Rhee P-L. Helicobacter pylori infection and motor fluctuations in patients with Parkinson's disease. Mov Disord. 2008;23(12):1696-700.
Fahn S. The freezing phenomenon in parkinsonism. Adv Neurol. 1995;67:53-63.
Del Sorbo F, Albanese A. Levodopa-induced dyskinesias and their management. J Neurol. 2008;255(Suppl):32-41.
Fox SH, Katzenschlager R, Lim S-Y, Barton B, de Bie RMA, Seppi K, et al. International Parkinson and movement disorder society evidence-based medicine review: Update on treatments for the motor symptoms of Parkinson's disease. Mov Disord. 2018;33(8):1248-66.
Ferreira JJ, Katzenschlager R, Bloem BR, Bonuccelli U, Burn D, Deuschl G, et al. Summary of the recommendations of the EFNS/MDS-ES review on therapeutic management of Parkinson's disease. Eur J Neurol. 2013;20(1):5-15.
Moreno López CL, Bernal Pacheco O, Barrios Vincos G, Arango Uribe G, Cerquera Cleves C, Orozco Vélez JL, et al. Consenso de la Asociación Colombiana de Neurología sobre el uso de apomorfina en la enfermedad de Parkinson. Acta Neurol Colomb. 2018; 34:25-39.
Okun MS, Tagliati M, Pourfar M, Fernandez HH, Rodriguez RL, Alterman RL, et al. Management of referred deep brain stimulation failures: a retrospective analysis from 2 movement disorders centers. Arch Neurol. 2005;62(8):1250-5.
Weaver FM, Follett K, Stern M, Hur K, Harris C, Marks WJJ, et al. Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA. 2009;301(1):63-73.
Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schafer H, Botzel K, et al. A randomized trial of deep-brain stimulation for Parkinson's disease. N Engl J Med. 2006;355(9):896-908.
Williams A, Gill S, Varma T, Jenkinson C, Quinn N, Mitchell R, et al. Deep brain stimulation plus best medical therapy versus best medical therapy alone for advanced Parkinson's disease (PD SURG trial): a randomised, open-label trial. Lancet Neurol. 2010;9(6):581-91.
Weaver FM, Follett KA, Stern M, Luo P, Harris CL, Hur K, et al. Randomized trial of deep brain stimulation for Parkinson disease: thirty-six-month outcomes. Neurology. 2012;79(1):55-65.
Schuepbach WMM, Rau J, Knudsen K, Volkmann J, Krack P, Timmermann L, et al. Neurostimulation for Parkinson's disease with early motor complications. N Engl J Med. 2013;368(7):610-22.
Morgante L, Morgante F, Moro E, Epifanio A, Girlanda P, Ragonese P, et al. How many parkinsonian patients are suitable candidates for deep brain stimulation of subthalamic nucleus? Results of a questionnaire. Parkinsonism Relat Disord. 2007;13(8):528-31.
Moro E, Volkmann J, Konig IR, Winkler S, Hiller A, Hassin-Baer S, et al. Bilateral subthalamic stimulation in Parkin and PINK1 parkinsonism. Neurology. 2008;70(14):1186-91.
Lohmann E, Welter M-L, Fraix V, Krack P, Lesage S, Laine S, et al. Are parkin patients particularly suited for deep-brain stimulation? Mov Disord. 2008;23(5):740-3.
Shih LC, Tarsy D. Deep brain stimulation for the treatment of atypical parkinsonism. Mov Disord. 2007;22(15):2149-55.
Lang AE, Houeto J-L, Krack P, Kubu C, Lyons KE, Moro E, et al. Deep brain stimulation: preoperative issues. Mov Disord. 2006;21(Suppl 14):S171-96.
Kleiner-Fisman G, Herzog J, Fisman DN, Tamma F, Lyons KE, Pahwa R, et al. Subthalamic nucleus deep brain stimulation: summary and meta-analysis of outcomes. Mov Disord. 2006;21(Suppl 14):S290-304.
Bronstein JM, Tagliati M, Alterman RL, Lozano AM, Volkmann J, Stefani A, et al. Deep brain stimulation for Parkinson disease: an expert consensus and review of key issues. Arch Neurol. 2011;68(2):165.
Voon V, Krack P, Lang AE, Lozano AM, Dujardin K, Schupbach M, et al. A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease. Brain. 2008;131(Pt 10):2720-8.
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