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Yıl:1996; Cilt: 34; Sayı: 3-4>> Özet
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Yeni Symposium; 1996;34(3-4):79-82
Levodopa'ya Bağlı "Nonmotor" Flüktüasyonlar
H Apaydın, N Ergin, G Somay, S Özekmekçi
Cerrahpaşa Tıp Fakültesi Nöroloji Ana Bilim Dalı
Bu çalışmada levodopa (LD) kullanan Parkinson hastaları içinde "nonmotor" flüktüasyon (NMF) gösterenler
(I. Grup) belirlenmiş, benzer komplikasyon göstermeyenlerle (II. Grup) hastalık başlangıç yaşı (HBY),
LD kullanma süresi ve doz sonu fenomeni gibi parametreler bağlamında kıyaslanmıştır. 216 Parkinson
hastasının % 9.2'sinde bunların içinde motor flüktüasyonu (MF) olan 69 hastanın da % 29'unda (n=20)
NMF vardı. Bunlar duysal (n=5), otonom (n=10), psişik (n=3) veya kombine (n=2) özellikteydi. HBY ort. i.
grupta 53, diğerinde 59 (p<0.01), iki grupta LD kullanma süresi ort. Sırasıyla 7.7 ve 4.3 yıl idi (p<0.01).
Doz sonu fenomeni i. Grupta % 90, Il.'de % 26 oranında mevcuttu (p<0.001). iki grupta da ilk semptomdan
ve LD başlamasından sonra ortaya çıkma zamanı arasındaki süreler farklı değildi. Çalışmanın sonuçlarında
MF'u olanların yaklaşık 1/3'ünde NMF da görülebildiğini bunlarda HBY'nın daha erken olduğunu,
LD kullanma süresiyle ilişkili olduğunu görmekteyiz.
Levodopa-induced non motor fluctuations in Parkinson's disease
In this study, patients with Parkinson's disease (PD) who had non-motor fluctuations (NMFs) (Group i) were
compared to PD patients without NMFs (Group ii), in terms of age at onset of PD, duration of PD and
of levodopa treatment and frequency of end of dose phenomenon. These NMFs were of sensorial (n=5),
autonomic (n=10), psychic (n=3) or mixed (n=2) nature. In both groups, the mean age at onset wasfound
53 and 59 [year]s respectively (p<0.01). The mean duration of levodopa treatment was respectively 7.7 and
4.3 [year]s (p<0.01). End of dose phenomenon was observed in 90 % of the first and 26 % of the second
group (p<0.001). The time interval between the appearance of the first symptom and also initiation of levodopa
and NMFs did not diffet between the two groups. According to the results of our study, levodopainduced
NMFs were not common in PD; approximately 1/3 (n=18) of PD patients with MFs (n=69) showed
also NMFs. In patients with NMFs, age-onset was found earlier and presence of NMFs were correlated to
the duration of levodopa treatment.

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