J Mov Disord.  2020 Jan;13(1):57-61. 10.14802/jmd.19051.

Rescue Levodopa/Carbidopa Intestinal Gel for Secondary Deep Brain Stimulation Failure

Affiliations
  • 1Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
  • 2Department of Neurology, St. Luke’s Medical Center, Quezon City, Philippines
  • 3Department of Psychiatry, Juntendo University School of Medicine, Tokyo, Japan
  • 4Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan
  • 5Department of Research and Therapeutics for Movement Disorders, Juntendo University School of Medicine, Tokyo, Japan
  • 6Department of Gastroenterology and Minimally Invasive Surgery, Juntendo University School of Medicine, Tokyo, Japan

Abstract


Objective
The long-term efficacy of deep brain stimulation (DBS) for motor fluctuations in advanced Parkinson’s disease (PD) has been well established; however, motor fluctuations may recur over time despite multiple adjustments of DBS settings and medications.
Methods
We conducted a retrospective chart review of three patients for whom levodopa-carbidopa intestinal gel (LCIG) was additionally administered as a rescue therapy for secondary DBS failure due to the recurrence of motor fluctuations.
Results
The three patients had advanced PD with a disease duration of 14–19 years, and had undergone DBS for motor fluctuations refractory to standard medical management. LCIG was administered to the patients because of symptom recurrence years after DBS and provided complementary effects in all patients.
Conclusion
The cases presented here show that rescue LCIG therapy may be a complementary treatment option for patients with post-DBS advanced PD who have a recurrence of troublesome motor complications.

Keyword

Deep brain stimulation; Globus pallidus; Infusion pump; Parkinson’s disease; Subthalamic nucleus
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