Apomorphine and levodopa challenge in patients with a focal midbrain lesion.
Three patients who presented with parkinsonian signs resulting from a focal midbrain lesion are reported. In all patients parkinsonian features occurred acutely and improved following acute challenge with apomorphine but not with levodopa. Remission of parkinsonian signs occurred spontaneously to a different degree. Inconsistent clinical response following administration of levodopa has been well documented in patients with focal midbrain lesions associated with parkinsonian signs; however, the efficacy of apomorphine has not been tested before. Anatomic or etiologic features do not allow us to predict in which cases parkinsonian signs secondary to a midbrain lesion would respond to levodopa or to dopamine agonists. A trial with apomorphine is warranted in all such cases.
Moro
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Istituto di Neurologia, Università Cattolica del Sacro Cuore, Rome, Italy.
Albanese
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A
D000328:Adult; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001058:Apomorphine / Q000008:administration & dosage / Q000627:therapeutic use*; D001925:Brain Damage, Chronic / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008636:Mesencephalon / Q000293:injuries* / Q000473:pathology; D008875:Middle Aged; D010302:Parkinson Disease, Secondary / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D007980:Levodopa; D001058:Apomorphine