Science News (Parkinson’s Disease Foundation):

Individuals with Parkinson’s Resting Tremor less likely to experience the troubling Levodopa side effect

After long-term treatment with Levodopa some people with Parkinson’s disease (PD) experience jerky, involuntary movements of arms, legs, or head, a condition known as Dyskinesia. While the causes of Levodopa-induced Dyskinesia (LID) are still unclear, a new study published in the August 2011 issue of Archives of Neurology has revealed that people who have a resting tremor when diagnosed with Parkinson’s are less likely to experience this unpleasant side effect.

For many people with Parkinson’s, the first obvious sign of their disease is shaking of the hands when the muscles are relaxed and at rest – a so-called resting tremor. Previous research has shown that people with resting tremors often have a different course of Parkinson's than those who do not. Stefan Kipfer, M.D. of the University of Berne in Switzerland, wondered if resting tremors could also predict a person's likelihood of developing LID. To answer this question, Dr. Kipfer and his colleagues analyzed data from 85 people with Parkinson’s who were in the database of the Movement Disorders Center in Berne, Switzerland.

Results were as follows:

1. Thirty–nine of the 85 people with Parkinson’s had LID.

2. People with Parkinson’s with LID had a longer duration of Parkinson's, a younger age of onset, more axial motor symptoms such as abnormal posture and gait, and were less likely to have resting tremors as the first sign of disease.

3. The absence of a resting tremor at diagnosis was a strong predictor of LID, independent of daily levodopa dose or duration of Parkinson’s.

What does it mean?

Parkinson's is a very heterogeneous disease, one in which different people may have different presenting symptoms and different disease courses. Resting tremor is perhaps the most recognizable sign of Parkinson’s, yet only about half of all people with Parkinson’s exhibit this symptom at diagnosis. Studies have shown that people who experience resting tremors as an initial sign of Parkinson’s have a slower disease progression and respond differently to therapies than those who do not.

Some people with PD develop LID months or years after treatment begins. Much time and energy is being devoted to finding clinical and biological tools that can estimate disease progression in different individuals. This retrospective study is part of that effort and suggests that doctors might be able to predict a person’s likelihood of developing LID based on whether or not they have resting tremors as an initial manifestation of their disease. This knowledge could allow doctors to better prepare and monitor individuals with Parkinson’s for this troubling side effect.

The above fact was revealed in August 2011 while in my wife’s case the disease was established in the year 1995 i.e., after 16 years so I couldn't save her from developing LID early. She had fewer resting tremors and I should have given her a minimum dose of Sinemet (Levodopa) in the early stages.

Below I am going to share my experience regarding Parkinson's disease throughout the 25 years in my wife's case as to how the disease was declared and progressed with time. In this, I will also enclose the prescriptions of different renowned Neuro Physicians of India only to help Parkinson's patient and their caretakers. I request not to use the prescriptions as I am not a doctor and as already said that different people have different presenting systems, in that case, a good Neuro Physician should be consulted. In this reference, I want to share that I have tried every type of pathy available in India but except allopathy, ( not a permanent cure either ) no treatment gave any relief.

Note: I am not a doctor, please consult a Neuro physician for diagnosis and treatment for Parkinson's, here I have narrated the journey of my wife's Parkinson's journey.