Symptomatic respiratory disturbance as a consequence of levodopa (L-dopa) therapy for Parkinson's disease (PD) has been described only rarely and may be underrecognized in clinical practice. We report on two patients with PD in whom the introduction or augmentation of L-dopa therapy was associated with the development of irregular and rapid breathing. Analysis of breathing patterns before and after L-dopa demonstrated a striking change in respiratory rate after administration of L-dopa, with the emergence of irregular tachypnea alternating with brief periods of apnea, in a pattern consistent with a central origin. In both cases, the temporal relationship of the respiratory disturbance to the administration of L-dopa suggested a peak-dose drug effect. Previous reports of L-dopa-induced respiratory dyskinesia are reviewed, and the potential mechanisms whereby L-dopa might influence the central control of respiration to produce irregular breathing patterns are discussed.
The major features of akinetic‐rigid syndromes are bradykinesia (small, slow movements), rigidity and tremor, often summarised as “parkinsonism”.
Approximately 80% of akinetic‐rigid syndromes are due to Parkinson's disease.
Treatment of Parkinson's disease should be determined by level of disability and handicap.
The combination of levodopa and peripheral dopa‐decarboxylase inhibitor is the most efficacious symptomatic treatment for Parkinson's disease.
Motor fluctuations appear after 2–3 years of levodopa treatment, and affect at least 50% of patients after five years.
Surgery can relieve refractory tremor and dyskinesias, but does not alter disease progression or need for drug therapy.
Copper plate etching depends greatly upon composition. Since the prints depicted herein use only black, white, and a variety of greys, color cannot be depended upon to compensate for composition. The particular problem that these prints are trying to solve is one of spacial relationships in composition. As can be seen there is a gradual progression to more simplified, general areas of positive and negative space.
Involuntary movements or hyperkinesias are classified into syndromes of chorea, ballism, tremor, dystonia, myoclonus and tics.
The hyperkinesias are caused by disturbances in the circuitry connecting the cerebral cortex, thalamus, basal ganglia and cerebellum.
Drugs are a common cause of movement disorders.
The aim of management is to characterise the movement disorder, identify and treat the cause or institute symptomatic treatment.
The genetic basis of many movement disorders is increasingly recognised. Where there are potential implications for family members, accurate diagnosis and counselling are particularly important.
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