[Pain fluctuations in Parkinson's disease]

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.

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.

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.