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Duodenal delivery of levodopa for on‐off fluctuations in parkinsonism: Preliminary observations
Author(s) -
Kurlan Roger,
Rubin Allen J.,
Miller Charlyne,
RiveraCalimlim Leonor,
Clarke Allan,
Shoulson Ira
Publication year - 1986
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410200213
Subject(s) - levodopa , parkinsonism , gastric emptying , duodenal ulcer , medicine , gastroenterology , anesthesia , parkinson's disease , stomach , disease
The pathogenesis of on‐off motor fluctuations in parkinsonism remains incompletely understood, but slowed or erratic gastric emptying of orally administered levodopa may be involved. In 3 patients with resistant on‐off fluctuations, direct duodenal continuous infusion of levodopa via a nasoduodenal tube resulted in a heightened therapeutic effect, including a reduction in motor fluctuations. In 1 of these patients, continuous duodenal levodopa infusion produced greater benefit than did intermittent duodenal levodopa administration. Direct duodenal delivery of levodopa lessens the problems with gastric emptying and may be suitable for long‐term therapy in selected patients with resistant on‐off motor fluctuations.