左旋多巴/卡比多巴肠凝胶挽救术治疗继发性脑深部电刺激失败
Rescue Levodopa/Carbidopa Intestinal Gel for Secondary Deep Brain Stimulation Failure.
作者信息
Bautista Juan Miguel Pilar, Oyama Genko, Nuermaimaiti Maierdanjiang, Sekimoto Satoko, Sasaki Fuyuko, Hatano Taku, Nishioka Kenya, Ito Masanobu, Umemura Atsushi, Ishibashi Yuji, Shimo Yasushi, Hattori Nobutaka
机构信息
Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.
Department of Neurology, St. Luke's Medical Center, Quezon City, Philippines.
出版信息
J Mov Disord. 2020 Jan;13(1):57-61. doi: 10.14802/jmd.19051. Epub 2020 Jan 31.
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.
目的
脑深部电刺激术（DBS）对晚期帕金森病（PD）运动波动的长期疗效已得到充分证实；然而，尽管对DBS设置和药物进行了多次调整，但运动波动仍可能随时间复发。
方法
我们对三名患者进行了回顾性病历审查，这三名患者因运动波动复发导致DBS继发性失败，额外接受左旋多巴-卡比多巴肠凝胶（LCIG）作为挽救治疗。
结果
这三名患者均为晚期PD，病程为14 - 19年，因标准药物治疗难以控制的运动波动接受了DBS治疗。由于DBS术后数年症状复发，对这些患者使用了LCIG，且在所有患者中均产生了互补效应。
结论
本文介绍的病例表明，挽救性LCIG治疗可能是DBS术后晚期PD且出现棘手运动并发症复发患者的一种补充治疗选择。
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