RESUMEN
OBJECTIVE: To specify the character of pain syndromes and determine their relationship with main symptoms of ON and OFF periods in patients with complications of long-term treatment with levodopa medications. MATERIAL AND METHODS: Authors examined 40 patients with Parkinson's disease (27 women and 13 men), mean age 69.2±8 years (from 62 to 85 years), illness duration 9.2±1.2 years (from 7 to 11 years), duration of treatment with levodopa 6.9±1.2 years (from 5 to 9 years). The severity of disease course, character and intensity of pain syndrome were assessed. RESULTS AND CONCLUSION: We described pain syndromes that had differences in the pathogenesis and localization. Adjustment of the antiparkinsonian treatment resulted in the decrease in their severity. Motor fluctuations and drug-induced dyskinesia that was accompanied by pain sensations were the most frequent signs of Parkinson's disease during its progression. The pain syndrome was related to main symptoms of the ON and OFF period in patients with complications of long-term treatment with levodopa. The pain fluctuations had both nociceptive and central neuropathic pain phenotypes.
Asunto(s)
Dolor/fisiopatología , Enfermedad de Parkinson/fisiopatología , Anciano , Anciano de 80 o más Años , Antiparkinsonianos/efectos adversos , Antiparkinsonianos/uso terapéutico , Progresión de la Enfermedad , Discinesia Inducida por Medicamentos/etiología , Discinesia Inducida por Medicamentos/fisiopatología , Femenino , Humanos , Levodopa/efectos adversos , Levodopa/uso terapéutico , Masculino , Persona de Mediana Edad , Dolor/inducido químicamente , Dolor/etiología , Dimensión del Dolor , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/tratamiento farmacológicoAsunto(s)
Síndromes del Dolor Miofascial/diagnóstico , Síndromes del Dolor Miofascial/etiología , Neuralgia/diagnóstico , Neuralgia/etiología , Enfermedad de Parkinson/complicaciones , Anciano , Anciano de 80 o más Años , Antiparkinsonianos/uso terapéutico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Síndromes del Dolor Miofascial/fisiopatología , Neuralgia/fisiopatología , Enfermedad de Parkinson/tratamiento farmacológicoRESUMEN
The paper considers the CT features of vertebrogenic lumbosacral radicular lesions in patients with radicular and nonradicular lumbar ischialgias. Ninety patients were divided into three groups according to the degree of clinical manifestations of radicular disorders. Four CT patterns of radicular alterations were identified: dislocation, compression, aggregation, and conglomeration. There were differences in the frequency of different CT patterns in patients from different clinical groups. Combining the CT patterns of radicular lesions into occupational and contact types determined a correlation of the severity of radicular disorders and the occupational type of changes in the root.