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Parkinson's Disease

Wearing off dyskinesia

11/08/1999

Question:

I have suffered much from very heavy wearing off dyskinesia, which after a one sided pallidotomy has been reduced, but now is back on my not treated side. Because my voice has been weakened by the first pallidotomy I don`t want to let another surgery done ,unless absolutely necessity. Some neuro`s in Europe say that anti-glutamate could be helpfull againdt wearing off dysk. What do you think?

Answer:

Gluatamate antagonists can certainly reduce the severity and duration of dyskinesias. The most common drug in this category that is used in treating PD is Amantadine (Symmetrel). It is used in early PD as a levodopa sparing agent. However, more recently it has found new use as an antidyskinetic agent due to its anti-glutamate properties. Other agents that have been reported to have some benefit in this regard include dextromethorphan and riluzole. Using higher doses of dopamine agonists, while reducing the Sinemet dose is another option. Finally, in terms of surgical options, deep brain stimulation of the pallidum can be an alternative to pallidotomy.

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Response by:

Arif Dalvi, MD
Assistant Professor
College of Medicine
University of Cincinnati