Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

Levodopa-carbidopa intestinal gel treatment introduced by surgical gastrostomy in a patient of Parkinson's disease after Billroth II gastrojejunostomy

Tomohito Nakano, M.D.1), Daisuke Hirozawa, M.D.1), Munehisa Shimamura, M.D., Ph.D.1)2), Tsutomu Sasaki, M.D., Ph.D.1), Kensuke Ikenaka, M.D., Ph.D.1) and Hideki Mochizuki, M.D., Ph.D.1)

1)Department of Neurology, Graduate School of Medicine, Osaka University
2)Department of Health Development and Medicine, Graduate School of Medicine, Osaka University

A 68-year-old man, who had received Billroth II gastrojejunostomy because of duodenal ulcer at the age of 20, was diagnosed to have Parkinson's disease at age 57 years. The drug therapy has been effective in the first 10 years, however, recently he was suffering from troublesome dyskinesia and wearing-off in spite of diligent drug adjustments. Although the indication of levodopa-carbidopa intestinal gel (LCIG) treatment was good, percutaneous endoscopic gastrostomy was difficult because of abdominal adhesion. Therefore, we introduced LCIG by surgical gastrostomy. After LCIG therapy, wearing-off and dyskinesia disappeared. This is the first case of Parkinson's disease patient with LCIG therapy by surgical gastrostomy in Japan.
Full Text of this Article in Japanese PDF (1296K)

(CLINICA NEUROL, 58: 570|573, 2018)
key words: Parkinson's disease, continuous dopaminergic stimulation, levodopa-carbidopa intestinal gel, percutaneous endoscopic gastrostomy, surgical gastrostomy

(Received: 5-Feb-18)