How is heterokinesia treated in patients with Parkinson’s disease?

  The type of xerodynia in Parkinson’s disease patients varies, as does the treatment.  For patients with Parkinson’s disease taking levodopa preparations who develop xerostomia, the first consideration is to reduce the dose of levodopa, such as the class dose of methyldopa or the agent of benzodiazepine. At the same time, if the patient develops aggravation of the original symptoms of Parkinson’s disease or shortening of the opening period after reducing the dose of levodopa, then it is appropriate to increase the B-type monoamine oxidase inhibitor – Strangely enough, or add the dopamine receptor agonist DD Senfuro, etc.  To date, the mechanism of biphasic heterodynia is still unclear, so a more consistent treatment is lacking. For different patients, additional dopamine agonists, or the application of diffusible methyldopa, increasing the number of doses and changing different medications can be used according to the specific characteristics of the individual.  Dystonia often manifests as painful spasms of the lower legs and feet, most of which occur in the morning before dosing, and can be treated with restoratives or the relatively long half-life dopamine agonist DD Tysudar before the patient sleeps at night. For more limited dystonia characterized mainly by spasticity, when oral medications are ineffective or cannot be taken due to side effects of medications, local injection of botulinum toxin type A can be considered for treatment, sometimes with good results.  Amantadine and clozapine are the few drugs that are effective for allodynia. When applying these two drugs, care should be taken to start with small doses, take them under the guidance of a doctor, pay attention to the occurrence of their related side effects, and review regularly with blood routine, liver function, electrocardiogram, etc. For those who are not well treated with drugs, deep brain stimulation (DBS), also called brain pacemaker therapy, can be considered. On the one hand, deep brain electrical stimulation can directly treat xenokinesia, and on the other hand, it can achieve the purpose of treating xenokinesia by reducing the dosage of drugs used to treat Parkinson’s disease.