Kataoka Hiroshi, Sawada Yasuhiko, Shimozato Naotaka, Inatomi Shinichiro, Iguchi Naohiko, Yoshiji Hitoshi, Sugie Kazuma
Department of Neurology, Nara Medical University, Kashihara, Nara, Japan.
Third Department of Internal Medicine, Nara Medical University, Kashihara, Nara, Japan.
Clin Park Relat Disord. 2020 Sep 25;3:100073. doi: 10.1016/j.prdoa.2020.100073. eCollection 2020.
Apraxia of eyelid opening (AEO) has been associated with levodopa. It has also been linked to impaired function of the frontal lobe, with the dopaminergic neuron projected to the frontal lobe. However, dopaminergic treatment for AEO is still controversial. Here we describe two patients with both Parkinson's disease (PD) and AEO, who responded differently to a continuous intrajejunal levodopa-carbidopa intestinal gel (LCIG) infusion. One of the patients manifested a deterioration of AEO after LCIG infusion, and off-periods were shortened by the decrease in the severity of dyskinesia. After discontinuing the use of LCIG, there was an improvement in the patient's ability to open her eyelids. The other patient had AEO prior to LCIG treatment, and this treatment spontaneously elevated her eyelids. These two PD patients raised the concern as to whether AEO may be a critical symptom for the indication of LCIG treatment. The different responses to LCIG might have been due to the fluctuation in brain dopamine levels during LCIG treatment.
眼睑开合失用症（AEO）与左旋多巴有关。它还与额叶功能受损有关，多巴胺能神经元投射到额叶。然而，多巴胺能治疗AEO仍存在争议。在此，我们描述了两名患有帕金森病（PD）和AEO的患者，他们对持续空肠内输注左旋多巴-卡比多巴肠凝胶（LCIG）的反应不同。其中一名患者在输注LCIG后出现AEO恶化，运动障碍严重程度降低使关期缩短。停用LCIG后，患者的眼睑开合能力有所改善。另一名患者在LCIG治疗前有AEO，该治疗使她的眼睑自发抬起。这两名PD患者引发了人们对AEO是否可能是LCIG治疗指征的关键症状的关注。对LCIG的不同反应可能是由于LCIG治疗期间脑多巴胺水平的波动。
