Abnormal involuntary eye movements were found in 8 of 27 patients with Parkinson's disease who were receiving levodopa and dopa decarboxylase inhibitors. The dyskinetic eye movements were smooth, slow, “to‐and‐fro” ocular deviations of large amplitude. They were suppressed by visual fixation and were prominent only in darkness or behind closed lids when patients were alert. They generally appeared in conjunction with involuntary body and limb movements but could occur alone. Many of the patients with ocular dyskinesias had prominent “on‐off” responses to levodopa. Ocular dyskinesias were present in 8 of 10 patients with bodily dyskinesias. This suggests that if recording conditions are appropriate, these eye movements will commonly be found in patients with Parkinson's disease who develop abnormal involuntary bodily movements while they are receiving levodopa therapy.
There are at present numerous pharmacological agents available for the control of parkinson symptoms. None are ideal; all have their limitations. The most potent is levodopa administered with a peripheral decarboxylase inhibitor. However, because its effectiveness declines after long-term use and side effects increase in severity, it should be reserved for individuals with established symptoms which are functionally impairing. In patients with minimal symptoms, anticholinergic agents, or agents which facilitate dopaminergic mechanisms normally operative in the nervous system, should be used. In a limited trial, deprenyl has produced promising results during this phase of parkinsonism. Deprenyl's major usefulness however, has been demonstrated in patients under treatment with levodopa which has become complicated by fluctuating responsesparticularly those of the end-start-dose variety. In such patients, it is possible to achieve an increase in "on" time and a decrease in the severity of parkinsonism. In most patients, such a response can maintained for a period of two years or longer.Key words: Parkinson's disease; plan of treatment in various phases; use of cholinergic and dopaminergic agents; "on-off" phenomena types; mechanisms and means of control; deprenyl (selegiline) indication.
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