Kataoka Hiroshi, Sawada Yasuhiko, Namizaki Tadashi, Shimozato Naotaka, Yoshiji Hitoshi, Ueno Satoshi
Department of Neurology, Nara Medical University, Kashihara, Japan.
Third Department of Internal Medicine, Nara Medical University, Kashihara, Japan.
Front Neurol. 2017 Oct 16;8:547. doi: 10.3389/fneur.2017.00547. eCollection 2017.
Dropped head can occur in patients with Parkinson's disease and make their quality of life unpleasant because they cannot obtain a frontal view. The pathophysiologic involvement of dopamine agonist or central or peripheral mechanisms has been proposed. Levodopa therapy with the withdrawal of dopamine agonists was sometimes effective, but the effect in most patients did not persist for the entire day. We describe a patient with Parkinson's disease whose dropped head responded throughout the day to the continuous intrajejunal infusion of levodopa-carbidopa intestinal gel (LCIG). During off-periods before treatment with LCIG, severe akinesia and freezing of gait were evident, and she could not continuously obtain a frontal view because of the dropped head. About 20 min after the intrajejunal infusion of LCIG, these features remarkably improved, and she could obtain a frontal view. The angle of dropped head was improved from 39.39 to 14.04°. This case suggests that infusion of LCIG can reduce the severity of dropped head for a longer period than oral levodopa.
帕金森病患者可能会出现低头现象，这会使其生活质量下降，因为他们无法获得正前方视野。多巴胺激动剂或中枢或外周机制的病理生理参与已被提出。停用多巴胺激动剂的左旋多巴治疗有时有效，但大多数患者的效果无法持续一整天。我们描述了一名帕金森病患者，其低头现象通过持续空肠内输注左旋多巴 - 卡比多巴肠凝胶（LCIG）在一整天内都有改善。在接受LCIG治疗前的非运动期，严重的运动不能和步态冻结很明显，并且由于低头她无法持续获得正前方视野。空肠内输注LCIG约20分钟后，这些症状显著改善，她能够获得正前方视野。低头角度从39.39°改善至14.04°。该病例表明，与口服左旋多巴相比，输注LCIG可以在更长时间内减轻低头的严重程度。
