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Motor Fluctuations in Parkinson's: The On-Off Rollercoaster
Published: Mar 25, 2024
Parkinson's disease often comes with a frustrating side effect of treatment - motor fluctuations. These are like a rollercoaster ride between feeling good ('on') and having symptoms return ('off').
The 'Wearing Off' Effect
As Parkinson's progresses, the effects of levodopa medication may not last as long. This 'wearing off' can cause symptoms to return before the next dose. It's like a car running out of gas before reaching the next fill-up station. Patients may experience stiffness, slowness, or tremors as the medication wears off.
Unpredictable 'Off' Periods
Sometimes, symptoms can return suddenly without warning. These unpredictable 'off' periods are like hitting unexpected traffic jams on your journey. They can be particularly frustrating as they don't follow a clear pattern related to medication timing.
Freezing of Gait
A particularly troublesome motor fluctuation is freezing of gait. This is when a person suddenly feels like their feet are glued to the floor. It's as if the brain's 'walk' signal gets interrupted. Freezing often occurs when starting to walk, turning, or passing through doorways.
Managing Motor Fluctuations
Doctors have several strategies to manage motor fluctuations. These may include adjusting medication dosages and timing, adding new medications, or considering advanced therapies like deep brain stimulation. It's like fine-tuning an engine to run more smoothly throughout the day.
Frequently Asked Questions
They affect up to 50% of patients within 5 years of starting levodopa therapy.
Yes, protein can interfere with levodopa absorption and timing meals matters.
Visual cues like laser pointers or lines on the floor can sometimes help.
They often become more frequent and severe as Parkinson's progresses.
Yes, stress and anxiety can exacerbate symptoms and fluctuations.
The Bottom Line
While motor fluctuations can be challenging, working closely with your doctor can help find the best management strategy for you.
Wondering how to better manage your motor fluctuations? Ask Doctronic about personalized strategies.
References
- Connolly BS, Lang AE. Pharmacological treatment of Parkinson disease: a review. JAMA 2014; 311:1670.
- Fox SH, Lang AE. Levodopa-related motor complications--phenomenology. Mov Disord 2008; 23 Suppl 3:S509.
- Nonnekes J, Snijders AH, Nutt JG, et al. Freezing of gait: a practical approach to management. Lancet Neurol 2015; 14:768.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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