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From the Department of Neurology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ.
Received February 1, 1996. Accepted in final form March 25, 1996.
Address correspondence and reprint requests to Dr. Jacob I. Sage, Department of Neurology, UMDNJ-Robert Wood Johnson Medical School, CN 19, New Brunswick, NJ 08903.
We studied the nature and frequency of nonmotor "off" phenomena in 130 consecutive patients with Parkinson's 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.
NEUROLOGY 1996;47: 1180-1183
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