Parkinson’s Disease

Treatment of Motor Fluctuations

As Parkinson’s disease (PD) progresses, patients experience off periods, the period during which medications lose their effectiveness. In this video, Dr. Stern discusses treatment options for patients with PD in this phase of their disease. He discusses how undesirable side effects can be managed using other medications. While deep brain stimulation (DBS), a more advanced neurosurgical procedure, is discussed in the section “Treating Advanced Parkinson’s”, there is some data to suggest its long term benefit even in this group of patients. Patients who are experiencing motor fluctuations can be reassured that there are many options.

Treatment of Motor Fluctuations

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Patient questions
  • What can I do to deal with the motor fluctuations?
  • As I am now on more medications, what are side effects I should look out for?
  • Are there other ways I can take Levodopa?
  • What are my biggest risk factors right now?
  • What can I do to maximize the efficacy of my medication?
Points you might want to raise during the discussion with your doctor
  • If not asked by doctor, make sure you mention any cases of falling or moments when you felt you came near to falling
  • Make sure to mention any non-motor complications (see the guide from the chapter “Approaches to Non-motor Symptoms”)
  • Frequency and times during the day that you experience motor fluctuations
  • Your ability to adhere to a medication regimen that potentially has you take multiple medications at different times in the day
  • Any incidences of involuntary movements (head bobbing, legs and arms twitching)
  • Updates on physical therapy
  • Any side effects of the medications that you are currently taking
Introduction to
Treatment
Approach to Non-Motor
Symptoms