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Prospective assessment of peripheral neuropathy in D uodopa‐treated parkinsonian patients
Author(s) -
Merola A.,
Zibetti M.,
Rizzone M. G.,
Troiano M.,
Artusi C. A.,
Angrisano S.,
Cocito D.,
Lopiano L.
Publication year - 2014
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12164
Subject(s) - peripheral neuropathy , medicine , prospective cohort study , diabetes mellitus , endocrinology
Background Although peripheral neuropathies ( PN ) have been described in patients with Parkinson's disease ( PD ) treated with oral dopaminergic therapies, anecdotal reports of subacute severe PN have been reported during treatment with enteral levodopa/carbidopa infusion ( D uodopa). Aim of the study We prospectively assessed clinical and electrophysiological data of 15 consecutive patients with PD treated with D uodopa for a mean follow‐up of 9 months. Methods Nerve conduction studies and a clinical evaluation with a standardized battery of peripheral neuropathy scales were performed at baseline and after a mean follow‐up of 9 months. Results At baseline, mild signs of PN were observed in three subjects, and vitamin B 12 serum levels were found to correlate with the amplitude of sural sensory action potentials. Follow‐up data were available for 10/15 subjects: one patient developed a subacute sensory‐motor PN and three subjects with pre‐existing PN showed a moderate worsening of electrophysiological and clinical features. Subclinical electrophysiological alterations of peripheral nerves were observed in two subjects. No significant changes were observed in vitamin B 12, folate, homocysteine and methylmalonic acid levels. Conclusions In this consecutive series of patients treated with D uodopa, we observed one subacute sensory‐motor PN and few length‐dependent alterations of peripheral nerves, similar to those described during oral levodopa treatment.