By Vincent Mosca
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Extra info for Clubfoot Guide for Parents
The first is nausea, but when carbidopa is combined with levodopa (the combination is used in the drug Sinemet), the nausea is reduced. The second is that at higher doses, fluctuations (called wearing off) and dyskinesia appear. In wearing off, the effect of a single dose lasts a shorter and shorter time. The addition of entacapone (sold under the brand name Comtan), a drug that blocks an enzyme called COMT, helps by extending the duration of action of Sinemet. Comtan does not work l eb03 11/14/02 1 0 0 11:51 AM Q & A Page 49 A B O U T P A R K I N S O N D I S E A S E axon endings striatum Treatment axon substantia nigra cell body nucleus dendrites Figure 3 Dopamine nerve cell alone; one tablet of Comtan should be given with each dose of Sinemet.
There are several such symptoms, and although it’s not possible to address them all, the most common ones are as follows. Retropulsion begin involuntarily propelled backward when trying to walk forward. 24 • Difficulty walking. This is common in PD, and for many it is a major problem. Difficulty walking results from a combination of slowness of movement and postural instability. In PD your steps become shorter and shorter and you sometimes shuffle. Your arms no longer swing while you walk, and your turning may become slower and requires more effort.
A small, cramped handwriting results from a combination of slowness of movement and rigidity. Over the years, without your often being aware of it, your handwriting may become smaller and smaller and more and more cramped, sometimes becoming illegible. A business associate, a bank clerk, or your accountant may first notice a change in your handwriting. • Pain. Pain in PD may take several forms. Sometimes it is a dull ache, a persistent nagging, or gnawing at a muscle. It is usually restricted to only one area at a time: a shoulder, an arm, calves of the legs, or the neck.