Frequency and types of motor fluctuations in patients presenting with advanced Parkinson's disease.

OBJECTIVE

To determine the frequency and types of motor fluctuations in patients presenting with advanced Parkinson's disease at a tertiary care hospital in Pakistan.

METHODOLOGY: This descriptive cross-sectional study was conducted at the Department of Neurology, Dr. Ruth K.M Pfau Civil Hospital, Karachi, from 1st June 2025 to 30th November 2025. A total of one hundred patients aged 25-75 years with advanced Parkinson's disease were enrolled through consecutive non-probability sampling. Demographic, clinical, and disease-related variables were documented, motor fluctuations were systematically assessed using clinical impression of severity index for Parkinson disease (CISI-PD), and data were analyzed in SPSS v26 with Chi-square tests (p ≤ 0.05).

RESULTS

In this cohort of one hundred advanced Parkinson's disease patients, the mean age was 49.9 years (±15.6), with a mean BMI of 27.5 (±8.7) and average disease duration of 7.2 years (±11.9). The sample included 51% men and 49% women. Motor fluctuations were reported in 42%, predominantly wearing off (28.6%) and dyskinesia (26.2%). No demographic, clinical, or treatment factor showed significant association (p>0.05), though smokers exhibited a higher frequency (51.2% vs.35.1%, p = 0.080).

CONCLUSION

Wearing-off episodes and dyskinesia were the most common fluctuations in this study.