title: Parkinsonism with 'on-off' phenomena. Intravenous treatment with levodopa after major abdominal surgery.
abstract: Continuous intravenous infusion of levodopa was used for eight days to manage a parkinsonian patient with "on-off" fluctuations who underwent abdominoperineal resection for carcinoma of the rectum. Reasonable control of parkinsonism was obtained initially with small doses of levodopa, but more than 4 g daily were eventually required. No adverse effects on cardiac rhythm, blood pressure, or gastrointestinal function occurred. Frequent adjustment of levodopa dosage was necessary in view of continuing "on-off" fluctuations. Severe akinesia, which can cause dysphagia, respiratory complications, and venous stasis in the legs, can benefit from this method of management after major abdominal surgery in a patient with advanced parkinsonism.
mesh_terms: D000005:Abdomen / Q000601:surgery*; D006801:Humans; D007275:Injections, Intravenous; D007980:Levodopa / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D011182:Postoperative Care; D012004:Rectal Neoplasms / Q000601:surgery
chemical_list: D007980:Levodopa