PT  - JOURNAL ARTICLE
AU  - Cheryl H. Waters
TI  - Managing the late complications of Parkinson's disease
AID  - 10.1212/WNL.49.1_Suppl_1.S49
DP  - 1997 Jul 01
TA  - Neurology
PG  - S49--S57
VI  - 49
IP  - 1 Suppl 1
4099  - http://n.neurology.org/content/49/1_Suppl_1/S49.short
4100  - http://n.neurology.org/content/49/1_Suppl_1/S49.full
SO  - Neurology1997 Jul 01; 49
AB  - Most patients with Parkinson's disease (PD) receiving chronic levodopa therapy eventually manifest one or more motor response complications, including "wearing-off" phenomena and "on-off" phenomena. Additionally, as the disease progresses, motor, neurologic, and neuropsychiatric complications increase and may include freezing spells, falls, dementia, depression, and psychosis. The management of patients with advanced PD presents a special clinical challenge because patients may experience an enhanced sensitivity to small changes in plasma levodopa levels and because they may suffer adverse reactions to antiparkinsonian drugs. Management of advanced PD is directed toward decreasing the dose of the offending drug while raising the dose of an alternative drug, with the goal of maintaining symptom control. In this article, the spectrum of late complications experienced by patients with advanced PD and their management are discussed.