A 69-year-old man with a history of Parkinson disease comes to the physician for evaluation of his symptoms. Since his last visit one year ago, he has had increased tremor and bradykinesia up to an hour before his next scheduled dose and sometimes feels like he does not respond to some doses at all. One week ago, he was entirely unable to move for about a minute when he wanted to exit an elevator. What should the physician inform the patient regarding his symptoms?

Question

A 69-year-old man with a history of Parkinson disease comes to the physician for evaluation of his symptoms. Since his last visit one year ago, he has had increased tremor and bradykinesia up to an hour before his next scheduled dose and sometimes feels like he does not respond to some doses at all. One week ago, he was entirely unable to move for about a minute when he wanted to exit an elevator.  What should the physician inform the patient regarding his symptoms?

Quizplus · Accepted Answer

Eductional Objective: Long-term treatment of Parkinson disease with levodopa can be complicated by periodic and sometimes unpredictable fluctuations in motor function.  This "on-off" phenomenon is thought to be a consequence of progressive nigrostriatal neurodegeneration leading to a decreased therapeutic window for levodopa.

A 69-Year-Old Man with a History of Parkinson Disease Comes