A (At)  0:21 13/12/95 -0500, Delana Vaughan ecrivait (wrote):
>I have just read a Leter to the Editor in the
>J.Neurol.Neurosurg.Psychiatr.1995;59:555-565 by D.E. Bateman. The title is "A
>simple model to explain the motor fluctuation seen in Parkinson's Disease."
>This letter ...
>Thanks. I think you'll find this a challenge worth pursuing.
>
>Delana Vaughan
 
About Dyskinesia.
----------------
- I intend to get and read Bateman's letter to the Editor.
 
- My PD, supposed to have begun in 1981, was discovered in 1983 and cured
from that moment with l-DOPA (Sinemet) with some episodic attempts of other
chemicals (bromocriptine, lisuride,...). After several years of l-DOPA
therapy (I write this note down as I remenber but I'll send more precise
details later on), I suffered from daily dyskinesia (each afternnon) which
proved difficult to master. So I underwent some sets of observations and
measurements in order to understand what was going on.
Surprisingly, I noticed a "yo-yo effect" i.e. alternate transitions of
short periods from stiffness to dyskinesia.
From these observations I was led to the conclusion that I was subject of a
undamped relaxation effect -i.e. a process including feedback controll-
which can, on severe circonstances lead to sudden blocking effects.
  Various models can lead to relaxation. For example, intersynaptic
recapture of dopamine could be invoked as well as  l-DOPA -> dopamine
inhibition by recycling of dopamine metabolites.
 
- On the basis of the undamped hypothesis, I succeeded to master a
dyskinesic situation by minute up/down variations (from 125mg up to 325mg
per week [sic!]).
But it took me months to achieved this.
 
- As far as the hereupon described case applies, dyskinesia shall be
avoided because the "yo-yo" effect may lead to a misunderstanding of the
situation (overdose) as off-state may appears more noticeable than
on-state.  Becare of
an overdose spiral!
 
- Nowadays, after more than 12 years of l-DOPA therapy with adjustments
from time to time, dyskinesia is no more a problem ("I hope it'll last" as
said Laetitia Bonaparte, mother of Napoleon I, in quite different
circumstances).
 
Looking forward for comments,
 
        Pierre-Andre Piron
 
 
Pierre-Andre PIRON
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