The motor complications of Parkinson’s disease are the side effects related to the motor activities of the patient that are caused due to the prolonged use of medication for treatment purposes. The motor complications may be essentially grouped into two main categories, namely-
Fluctuations- These include the symptoms like wearing off along with the on and off phase of Parkinson’s disease.
Dyskinesia- These are characterized by involuntary muscular movements like twitches and shaking of limbs and other body parts usually brought about by levodopa therapy.
What are the Various Forms of Motor Fluctuations That Occur Due To the Motor Complications?
Motor fluctuation is a broad category of motor complications associated with the Parkinson’s disease. The various symptoms of motor fluctuations involve-
Wearing Off Symptoms- One of the most common forms of fluctuation due to motor complications involves the symptom of wearing off. This usually happens due to long term use of levodopa. Due to the treatment, the patient in general may feel better after the intake of the medicinal drug. He may not feel the stiffness and other disabilities. Once the effect of the medication wears off, the symptoms come back to the patient. He may again feel the stiffness and become unable to move and walk properly. The wearing off occurs before the next prescribed dose. It is seen that this phenomenon tends to get severe as the disease progresses.
Duration: The wearing off for some patients may be for long hours, while for others it may last for few minutes.
Random Off: There may be a form of wearing off called the random off. This occurs irrespective of the time of the doses.
Delayed Kicking Off- Another form of fluctuation due to motor complications is delayed kicking off. This characteristically occurs when it takes a lot of time for the dose of levodopa to start its actions.
Freezing: Freezing is another form of fluctuation where the patient’s posture tends to freeze at any time for some duration of time.
Fluctuations: Fluctuations die to motor complications also involve falls due to inability of the patient to balance posture which may occur due to dopaminergic therapy.
How to Manage The Motor Complications Related To Parkinson’s Disease?
Go to Doctor: The most important and the initial methods of managing such complications of Parkinson’s disease are to inform the doctor. The patient in case of any form of uneasiness should inform the doctor immediately. The doctor will go through the doses and change the schedule according to the requirements. One must not stop the medications abruptly without informing the doctor.
Caregiver: The role of a caregiver for managing motor complications is of extreme importance when it comes to neurological disease like Parkinson’s disease. In case the patient encounters freezing, the caregiver should be with him for support and motivation.
Physical Assistance: Falls can be quite dangerous and may lead to fatal accidents too. One popular way to manage falls is using of wheel chair for the patient to move around. This way the patient does not have to walk on legs in order to move. Even while using wheelchair one must be aware of risky places like staircases.
Safe Home: Grab bars may be installed in the potentially dangerous places so that the patient may get quick support in case of accidents.
Lowering the Dosage- When it comes to dyskinesia, the doctor usually lowers the dose of levodopa in use. It has been seen that the lowest dose of the drug may increase the time for the starting of the symptoms of dyskinesia in the patient.
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