Zustandsschwankungen bei der Parkinson-Krankheit jenseits von On‑/Off-Fluktuationen

In addition to response fluctuations caused by the pharmacokinetics of dopamine replacement medication, further fluctuations, which are either not or only partially attributable to the effects of the medication, can occur in Parkinson’s disease. The spectrum of motor fluctuations ranges from brief episodes of gait freezing or tremor breakthroughs to severe akinetic crisis. Non-motor phenomena include discontinuous changes in cognition and vigilance. Systemic or disease-related complications such as dementia or orthostatic dysregulation may also contribute to these fluctuations. Additionally, external stimuli or intrinsic factors can lead to temporary changes in symptoms. Accurately classifying these fluctuations and distinguishing them from drug-induced response fluctuations is essential for appropriate management.