Parkinson’s Motor Fluctuations — UKMLA MCQ

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MediumNeurologyParkinson’s Motor FluctuationsUKMLA MRCP Part 1 PARA

A 65-year-old with Parkinson's disease has troublesome motor fluctuations on levodopa. Next step?

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Correct answer: C — Add a COMT inhibitor (entacapone)

COMT inhibitors reduce end-of-dose wearing-off with levodopa. Haloperidol worsens Parkinsonism. Carbamazepine/amitriptyline are not indicated. Stopping levodopa would worsen symptoms.

Reference: NICE Guideline: Parkinson’s disease in adults; BNF: Entacapone