Malnutritional neuropathy under intestinal levodopa infusion

Levodopa/Carbidopa intestinal gel infusion (LCIG) for Parkinson’s disease is under debate to provoke polyneuropathy (PNP). In our cohort of 20 thus treated patients, two developed debilitating axonal PNP with deficient pyridoxin and folate levels, and marginal cobalamin. Homocysteine was highly elev...

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Bibliographic Details
Published in:Journal of Neural Transmission 2012-03, Vol.119 (3), p.369-372
Main Authors: Klostermann, Fabian, Jugel, Constanze, Müller, Thomas, Marzinzik, Frank
Format: Article
Language:English
Subjects:
Aged
Carbidopa - administration & dosage
Carbidopa - adverse effects
Humans
Infusions, Parenteral
Levodopa - administration & dosage
Levodopa - adverse effects
Male
Malnutrition - chemically induced
Medicine
Medicine & Public Health
Middle Aged
Movement Disorders - Short communication
Neurology
Neurosciences
Neurotoxicity Syndromes
Parkinson Disease - drug therapy
Polyneuropathies - chemically induced
Psychiatry
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Description
Summary:Levodopa/Carbidopa intestinal gel infusion (LCIG) for Parkinson’s disease is under debate to provoke polyneuropathy (PNP). In our cohort of 20 thus treated patients, two developed debilitating axonal PNP with deficient pyridoxin and folate levels, and marginal cobalamin. Homocysteine was highly elevated. The neuropathies responded to vitamin replacement. We assume that LCIG can provoke PNP most likely of malnutritional origin. To avoid this side effect, the assessment of predisposing factors before treatment as well as neurophysiological and laboratory screenings appear necessary.
ISSN:0300-9564
1435-1463
DOI:10.1007/s00702-011-0689-3