L‐dopa‐induced respiratory disturbance in Parkinson's disease suppressed by tiapride

Keyser, Jacques De; Vincken, Walter

doi:10.1212/wnl.35.2.235

Cited by 50 publications

(27 citation statements)

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“…Symptomatic dyspnea with irregularities of respiratory rate and depth beginning 30 to 120 minutes after L-dopa, coinciding with peak L-dopa effect, has been reported in 6 patients. 1,[10][11][12][13] In 4 of these, respiratory patterns before and after L-dopa administration were characterized by using spirometry or plethysmography. 1,11,12 These respiratory abnormalities appeared after the introduction of L-dopa or an increase in L-dopa dose, and resolved with reduction of L-dopa dose.…”

Section: Discussionmentioning

confidence: 99%

“…1,[10][11][12][13] In 4 of these, respiratory patterns before and after L-dopa administration were characterized by using spirometry or plethysmography. 1,11,12 These respiratory abnormalities appeared after the introduction of L-dopa or an increase in L-dopa dose, and resolved with reduction of L-dopa dose. In 1 case, administration of the dopamine agonist tiapride suppressed the abnormal respiratory pattern.…”

Section: Discussionmentioning

confidence: 99%

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Disordered respiration as a levodopa‐induced dyskinesia in Parkinson's disease

2002

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Disordered respiration as a levodopa‐induced dyskinesia in Parkinson's disease

2002

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“…Keywords Voluntary cough Á Airflow Á Penetration Á Parkinson's disease Á Deglutition Á Deglutition disorders Symptoms of Parkinson's disease (PD) may include bradykinesia (slowness of movement), resting tremor, rigidity, postural abnormalities [1,2], respiratory difficulty (including dysrhythmias), [1,3], respiratory muscle weakness [1,4], and/or laryngeal muscle abnormalities [1]. Dysphagia (swallowing dysfunction) can occur in the early stages of PD and aspiration pneumonia is reported as the leading cause of death in PD patients [5,6].…”

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confidence: 99%

Voluntary Cough Production and Swallow Dysfunction in Parkinson’s Disease

et al. 2008

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Cough is important for airway clearance, particularly if penetration/aspiration of foreign material occurs during swallow. Measures of voluntary cough production from ten male participants with stage II-III Parkinson's disease (PD) who showed no videofluorographic evidence of penetration/aspiration (Group 1) were examined and compared with those of ten male participants with stage II-III PD who showed videofluorographic evidence of penetration/aspiration (Group 2). The degree of penetration/aspiration was expertly judged from the videofluorographic examinations of the participants' sequential swallow of a thin, 30-cc bolus. Measured cough parameters included inspiratory phase duration, inspiratory peak flow, compression phase duration, expiratory peak flow, expiratory rise time, and cough volume acceleration. Results indicated significant group differences for the majority of cough measures, except for inspiratory phase duration and inspiratory peak flow. A modest relationship existed between voluntary cough parameters and penetration/aspiration scores. Decreased ability to adequately clear material from the airway with voluntary cough may exacerbate symptoms resulting from penetration/aspiration, particularly for those with neurodegenerative disease. Measurement of voluntary cough may be useful for the evaluation of airway clearance ability.

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“…In Parkinsonian patients, an excessive duration of EMG activity of the inspiratory muscles in the course of the expiration phase [6] and prolongation of the strain period of the diaphragm [7] were observed. Drops in the forced vital capacity (FVC), total lung capacity (TLC), maximum lung ventilation (MLV), forced expiratory volume per 1 sec (FEV 1 ), Tiffno's index (FEV 1 %VC; this shift is combined with an increase in the residual ventilation, RV), and the total resistance of respiratory pathways (R rs ) [3,[8][9][10][11][12][13][14] are indicative of a noticeable restriction of the functional resources of the mechanical respiratory apparatus. At the same time, some experimenters reported that relatively normal indices of VC, FEV 1 %VC [15], and FEV 1 [9] are preserved in a considerable part of the patients; in these cases, obturation of the respiratory pathways corresponded only to a subclinical level.…”

Section: The State Of the Mechanical Apparatus Of Lung Ventilation In Pdmentioning

confidence: 99%