Discinesias induzidas por levodopa em 176 pacientes com doença de Parkinson

Discinesias induzidas por levodopa em 176 pacientes com doença de Parkinson

Alternative title Levodopa-induced dyskinesias in 176 parkisonian patients
Author Rocha, Maria Sheila G. Autor UNIFESP Google Scholar
Andrade, Luiz Augusto Franco de Autor UNIFESP Google Scholar
Ferraz, Henrique B. Autor UNIFESP Google Scholar
Borges, Vanderci Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Dyskinesias are frequently observed in parkinsonian patients during levodopa treatment. The occurrence of these movement disorders usually makes the therapeutic management of the patients very difficult. The clinical characteristics of 176 patients with dyskinesias were retrospectively studied. Dyskinesias occurred, on average, after 6,2 years of duration of Parkinson's disease and after 4.2 years on treatment with levodopa. Patients were more likely to have dyskinesias during more advanced stages (measured by Hoehn and Yahr scale). Peak of dose and square wave were the types of dyskinesia more frequently described and were associated with choreic movements in most cases. Dystonia occurred in 40% of the cases and was predominant in end of dose and diphasic dyskinesias. Thirty-five percent of dystonia cases presented as early morning dystonia. Chorea was the most frequent involuntary movement and mostly generalized. Dystonia was most commonly described in lower limbs. Orofacial dyskinesia, when occurred alone, was more frequently seen in old rather than young patients. When dyskinesia was unilateral it was more likely to occur in the side where Parkinson's disease was more severe.

A ocorrência de discinesias dificulta consideravelmente o manuseio terapêutico dos pacientes parkinsonianos tratados com levodopa. Estudamos as características clínicas das discinesias em 176 pacientes com diagnóstico de doença de Parkinson e tratados com levodopa. As discinesias ocorreram, em média, após 6,2 anos de duração da doença e após 4,2 anos de tratamento com levodopa. A maioria dos pacientes (90%) achava-se nos estágios II e III de Hoehn & Yahr por ocasião do início das discinesias. As discinesias mais frequentes foram as de pico de dose e contínua. Movimento do tipo distônico ocorreu em 40% dos casos e predominou nas discinesias de fim de dose e bifásica. Distonia matinal correspondeu a 35% dos casos de distonia. Movimentos coreiformes se manifestaram de forma generalizada em 43,2% dos casos. Movimentos distônicos predominaram nos membros inferiores. A discinesia, quando unilateral, ocorreu mais frequüentemente no hemicorpo mais comprometido pela doença de Parkinson. A discinesia orofacial, quando isolada, foi mais frequente nos pacientes mais idosos.
Keywords Parkinson's disease
dyskinesias
levodopa
doença de Parkinson
discinesias
levodopa
Language Portuguese
Sponsor Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Date 1995-12-01
Published in Arquivos de Neuro-Psiquiatria. Academia Brasileira de Neurologia - ABNEURO, v. 53, n. 4, p. 737-742, 1995.
ISSN 0004-282X (Sherpa/Romeo, impact factor)
Publisher Academia Brasileira de Neurologia - ABNEURO
Extent 737-742
Origin http://dx.doi.org/10.1590/S0004-282X1995000500004
Access rights Open access Open Access
Type Article
Web of Science ID WOS:A1995TG06300004
SciELO ID S0004-282X1995000500004 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/399

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