Neurol. praxi. 2014;15(5):278-280
Improving quality of life in advanced stage Parkinson's disease with intraduodenal levodopa infusions
- 1 Neurologická klinika, FN a LF UP, Olomouc
- 2 Radiologická klinika, FN a LF UP, Olomouc
Advanced stage of idiopathic Parkinson's disease is characterized particularly by motor fluctuations. These often cannot be controlled even when all the options of oral pharmacotherapy are utilized. One of the management options is then to use continuous intestinal L-DOPA infusions providing a more stable plasma concentration of L-DOPA. L-DOPA intestinal gel is administered by means of a portable pump and a tube that is inserted via percutaneous endoscopic gastrostomy directly into the terminal part of the duodenum where L-DOPA is resorbed. The effect of this treatment and its benefit in terms of improving motor fluctuations and thus the quality of life is documented by the present case report of a 70-year-old man with advanced stage Parkinson's disease.
Keywords: Parkinson's disease, L-DOPA, intestinal L-DOPA infusion
Published: November 18, 2014 Show citation
References
- Antonini A, Tolosa E. Apomorphine and levodopa infusion therapies for advanced Parkinson's disease: selection criteria and patient management. Expert Rev Neurother 2009; 9: 859-867.
Go to original source... 
Go to PubMed... - Bareš M, Rektorová I, Jech R, Farníková K, Roth J, Růžička E, Kaňovský P, Rektor I, Pavlík T, Uhlířová L, Vydlák J. Does WOQ9 help to recognize symptoms of non-motor wearing-off in Parkinson's disease? J Neural Transm 2012; 119(3): 373-380. Go to original source... Go to PubMed...
- Cotzias GC, Papavasiliou PS, Gellene R. Experimental treatment of parkinsonism with L-Dopa. Neurology 1968; 18(3): 276-267.
- Fernandez HH, Odin P. Levodopa-carbidopa intestinal gel for treatment of advanced Parkinson's disease. Curr Med Res Opin 2011; 27: 907-919. Go to original source... Go to PubMed...
- Fernandez HH, Vanagunas A, Odin P, Espay AJ, Hauser RA, Standaert DG, Chatamra K, Benesh J, Pritchett Y, Hass SL, Lenz RA. Levodopa-carbidopa intestinal gel in advanced Parkinson's disease open-label study: interim results. Parkinsonism Relat Disord 2013; 19(3): 339-345. Go to original source... Go to PubMed...
- Hauser RA. Levodopa: past, present, and future. Eur Neurol 2009; 62: 1-8. Go to original source... Go to PubMed...
- Kianička B, Žák J, Bareš M. Využití perkutánní endoskopické gastrostomie - přehled indikací, popis techniky a současné trendy v neurologii. Cesk Slov Neurol N 2012; 75/108(2): 165-169.
- Kurlan R, Rubin AJ, Miller C, Rivera-Calimlim L, Clarke A, Shoulson I. Duodenal delivery of levodopa for on-off fluctuations in parkinsonism: preliminary observations. Ann Neurol 1986; 20: 262-265. Go to original source... Go to PubMed...
- Olanow CW, Kieburtz K, Odin P, Espay AJ, Standaert DG, Fernandez HH, Vanagunas A, Othman AA, Widnell KL, Robieson WZ, Pritchett Y, Chatamra K, Benesh J, Lenz RA, Antonini A; LCIG Horizon Study Group. Continuous intrajejunal infusion of levodopa-carbidopa intestinal gel for patients with advanced Parkinson's disease: a randomised, controlled, double-blind, double-dummy study. Lancet Neurol 2014; 13(2): 141-149. Go to original source... Go to PubMed...
- Rinne UK. Problems associated with long-term levodopa treatment of Parkinson's disease Acta Neurol Scand 1983; 95(Suppl.): 19-26. Go to original source... Go to PubMed...
- Shoulson, Glaubiger GA, Chase TN. On-off response. Clinical and biochemical correlations during oral and intravenous levodopa administration in parkinsonian patients. Neurology 1975; 25: 1144-1148. Go to original source... Go to PubMed...
- Stocchi F, Vacca L, Ruggieri S, Olanow CW. Intermittent vs continuous levodopa administration in patients with advanced Parkinson disease: a clinical and pharmacokinetic study. Arch Neurol 2005; 62: 905-910. Go to original source... Go to PubMed...