[Continuous treatment with levodopa of Parkinson disease].
BACKGROUND
The advanced stage of Parkinson's disease is characterised by motor fluctuations which are often difficult to control on traditional, peroral levodopa medication. We present our experience and a literature search regarding a method for continuous intraduodenal administration of a levodopa/carbidopa gel (Duodopa).


METHODS
In a pilot study based on the compassionate use of continuous intraduodenal levodopa, patients were tested via nasoduodenal administration of the gel and on-off registration. For patients in whom a significant improvement in time in near-normal function per day was seen, permanent administration was started through a permanent duodenal port via percutaneous endoscopic gastrostomy with an inner catheter to the duodenal-jejunal transition.


CONCLUSIONS
In the nine patients tested, a significant functional improvement over time was seen. Five patients now have a permanent system with lasting good effect. Qualitative evaluation shows maintained good effect over a follow up time of up to 2.5 years (mean 19 months). We conclude that continuous enteral levodopa administration is a good and safe alternative especially for patients not offered deep brain stimulation. Its place among other treatment methods needs further assessment.
Lundqvist
Christofer
C
Nevrologisk avdeling, Akershus universitetssykehus, 1474 Nordbyhagen. luch@uus.no
Nystedt
Trond
T
Reiertsen
Ola
O
Grotli
Ragnvald
R
Beiske
Antonie Giaever
AG
D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage*; D002230:Carbidopa / Q000008:administration & dosage*; D004338:Drug Combinations; D004386:Duodenum; D006801:Humans; D007260:Infusion Pumps; D007980:Levodopa / Q000008:administration & dosage*; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*
D000978:Antiparkinson Agents; D004338:Drug Combinations; D007980:Levodopa; D002230:Carbidopa