Patients may fluctuate between periods of euphoria and hypomania when the medicines are working, and periods of panic and depression when the medications wear off. Antidepressants and anti-anxiety medications are frequently helpful. Some patients with Parkinson's disease may have severe spasm of a neck muscle or spasms of the eyelids leading to closure of the eyelids. These patients can benefit from Botox injections with relaxation of these muscles. Contraction of the eyelids closed or blepharoplasm must be distinguished from an inability to open the eye called eyelid apraxia, which is a sign of frontal lobe degeneration.
Dopamine normally inhibits the outflow of electricity from the subthalamic nucleus.
This activity can also be blocked by the placement of deep brain jamming electrodes, or pacemakers. Patients without dementia who have severe fluctuations in response to medications and severe sensitivity in response to minute amounts of levodopa are excellent candidates for pacemaker placement. We are almost out of time. This is what we are all fighting for, a cure. We are out of time.