Duodenal delivery of levodopa for on-off fluctuations in parkinsonism: Preliminary observations

✍ Scribed by Dr Roger Kurlan; Allen J. Rubin; Charlyne Miller; Leonor Rivera-Calimlim; Allan Clarke; Ira Shoulson

• Publisher: John Wiley and Sons
• Year: 1986
• Tongue: English
• Weight: 418 KB
• Volume: 20
• Category: Article
• ISSN: 0364-5134
• DOI: 10.1002/ana.410200213

✦ Synopsis

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 in- termittent 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.

Kurlan R, Rubin AJ, Miller C , Rivera-Calimlim L, Clarke A, Shoulson I: Duodenal delivery of levodopa for on-off fluctuations in parkinsonism: preliminary observations.