MCQ Neurology Answer 22

The Correct Answer is B

Important late complications of levodopa are the wearing off effect (transient deterioration shortly before the next dose) & the “on-off” phenomenon – abrupt but transient fluctuations in clinical state that occur frequently throughout the day & are unrelated to dosing schedule. The on-off phenomenon can be controlled in part by reducing the dosage interval, administering levodopa 1 hr before meals, & restricting dietary protein intake, or treatment with dopamine agonists. Selegiline (a MAOI) reduces the metabolic breakdown of levodopa & may also be helpful.


Dopamine agonists e.g. bromocriptine, have a similar side effect profile to levodopa but psychiatric side effects such as delusions & hallucinations are more common & dyskinesias are less common than with levodopa.


Benztropine can cause a variety of anticholinergic effects; confusions & hallucinations are especially troublesome in the elderly.

Category: Neurology MCQs