Preliminary Investigation of Risk Factors Causing Dyskinesias in Parkinson’s Disease in South Africa

Purpose: To determine the risk factors involved in the onset of dyskinesias in patients suffering from Parkinson’s disease in South Africa.
Methods: A questionnaire survey and medical record review were conducted. A total of 43 patients with Parkinson’s disease in two metropolitan areas were included in the study.
Results: The number of patients with dyskinesias indicated by medical records (n =10) was less than the number of patients with self-reported dyskinesias (n = 13). According to the patient interviews, the mean prescribed daily dose (PDD) of levodopa was 750 ± 452 mg. Twelve patients had been using levodopa for > 10 years. Mean PDD of levodopa according to the medical records was 809 ± 514 mg, with dyskinetic patients receiving a higher average PDD of 870 ± 590 mg. Half of the patients with dyskinesias were diagnosed more than 10 years ago. Patients with dyskinesias were diagnosed with Parkinson’s disease at a younger age (11.63 % dyskinetic patients were diagnosed between 40 and 60 years), and experienced longer disease duration. There were no gender differences (p = 0.80) in the incidence of dyskinesias.
Conclusion: Higher doses of levodopa, longer disease duration and a longer duration of levodopa therapy were risk factors for dyskinesias. Further studies are needed on the incidence of dyskinesias.

Keywords
Parkinson’s disease; Dyskinesias; Levodopa; Drug utilisation South Africa