Clinical approach to nonmotor sensory fluctuations in Parkinson's disease

Proposed treatments of NMSFs are based on whether they occur during “off” or “on” state. These include reduction of dopaminergic medication, use of long-acting dopamine agonists or controlled released levodopa (LD), surgical intervention, and/or targeted pharmacological intervention to minimize dopaminergic side effects. NMSFs might be related to dopaminergic mechanisms although difficulty in managing these symptoms with dopaminergic therapy suggests a different pathway. Conclusion: Recognition of NMSFs is important in the care of patients with Parkinson disease to prevent unnecessary interventions and for appropriate medication regimen adjustments.