Nonmotor fluctuations in patients with Parkinson's disease

TLDR

Previously unreported, or little appreciated, nonmotor “off” states include sensory dyspnea, nausea, facial flushing, cough, hunger, unilateral limb edema, proximal limb pain, and trigeminal neuralgia‑like pain. We studied 130 consecutive Parkinson’s disease patients with motor fluctuations to characterize nonmotor off phenomena, noting that 22 (17%) experienced end‑of‑dose events. Treatment modification improved nonmotor off symptoms in 9 of 12 patients (75%), and recognizing these phenomena can prevent unnecessary tests and treatments. Published in NEUROLOGY 1996;47:1180‑1183.

Abstract

We studied the nature and frequency of nonmotor "off" phenomena in 130 consecutive patients with Parkinson9s disease (PD) with motor fluctuations.Twenty-two patients (17%) experienced nonmotor fluctuations as an end-of-dose phenomenon. Previously unreported, or little appreciated, nonmotor "off" states include sensory dyspnea, nausea, facial flushing, cough, hunger, unilateral limb edema, proximal limb pain, and trigeminal neuralgia-like pain. We attempted treatment modification in 12 of 22 patients; nonmotor "off" symptoms improved in nine of these 12 patients (75%). Recognizing these phenomena will prevent unnecessary tests and treatments. <b>NEUROLOGY 1996;47: </b> 1180-1183