Diphasic Worsening of Freezing of Gait in Parkinson's Disease.
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ABSTRACT: Background
The relationship between freezing of gait (FOG) and levodopa response is complex. Some patients respond, some have no response and in some patients levodopa causes FOG. We present 2 cases demonstrating a diphasic worsening of FOG after levodopa dosing.Cases
Two PD patients with FOG were examined during the practically defined off state, the transition from off to on (15 and 22 minutes postdose), and in the full on state (45 and 60 minutes postdose). FOG was measured using Movement Disorder Society-Unified Parkinson's Disease Rating Scale part III, item 11: freezing of gait. Both patients experienced worsening of FOG during the transition followed by improvement during the on state. Case 1 had serum levodopa levels measured. Videos are provided.Conclusions
To our knowledge, this diphasic pattern of worsening of FOG has not been previously reported. The cause of this phenomenon is unknown but may relate to an inhibitory action of subthreshold levels of levodopa.
SUBMITTER: Perez Parra S
PROVIDER: S-EPMC7111566 | biostudies-literature | 2020 Apr
REPOSITORIES: biostudies-literature
Publications
Diphasic Worsening of Freezing of Gait in Parkinson's Disease.
Perez Parra Sahyli S McKay J Lucas JL Factor Stewart A SA
Movement disorders clinical practice 20200309 3
<h4>Background</h4>The relationship between freezing of gait (FOG) and levodopa response is complex. Some patients respond, some have no response and in some patients levodopa causes FOG. We present 2 cases demonstrating a diphasic worsening of FOG after levodopa dosing.<h4>Cases</h4>Two PD patients with FOG were examined during the practically defined <i>off</i> state, the transition from <i>off</i> to <i>on</i> (15 and 22 minutes postdose), and in the full <i>on</i> state (45 and 60 minutes po ...[more]
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