Session Information
Date: Thursday, June 8, 2017
Session Title: Other
Session Time: 1:15pm-2:45pm
Location: Exhibit Hall C
Objective: This study main objective is to prospectively report the 10-year incidence of polineuropathy in Parkinson´s disease patients from southern Spain treated with LCIG.
Background: Patients with Parkinson’s disease (PD) treated with oral levodopa have a higher prevalence of chronic, prevalently sensory, usually mild axonal polyneuropathy (PNP). Acute and chronic PNP have been reported in PD patients treated with levodopa/carbidopa intestinal gel infusion (LCIG). Although several aspects of their incidence and pathogenesis still remain to be clarified, several studies showed alterations in B12, homocysteine and folic acid as well as higher equivalent levodopa daily dose.
Methods: We performed a prospective study in a movement disorders unit of a reference university hospital between 2007-2016. We analyzed all patients treated with LCIG, describing the clinical, hematological and electrophysiological characteristics of the patients who developed acute or chronic PNP.
Results: A total of 41 patients were included. No patient presented prior to the initiation of treatment with LCIG symptoms suggestive of PNP. During the follow-up period 9 patients (21,9%) developed PNP, 4 (9,7%) acute and 5 (12,19%) chronic. In all cases of acute PNP and in a case of chronic PNP, treatment with LCIG was stopped. All PNP were supplemented with folic acid and B12, showing a clinical improvement and/or substantial stability at the following evaluations. In two cases of acute PNP a nerve biopsy was performed showing axonal degeneration and endoneural infiltration. Higher levodopa-equivalent daily dose, B12 levels, folic acid levels and homocysteine levels were associated with development of PNP.
Conclusions: PNP is very common in PD patients from southern Spain treatment with LCIG. No clear causative factors has been recognized although homocysteine-mediated neurotoxicity seems to be one of the factors involved in pathophysiology. However genetic and/or environmental factors must be involved. Prospective, large-scale, long-term studies are needed to clarify the pathogenesis of PNP in PD patients in different populations.
To cite this abstract in AMA style:
F. Carrillo, S. Jesus, L. Vargas, M. Bernal, M.T. Caceres, A.D. Adarmes, M. Carballo, P. Mir. Polyneuropathy in patients with Parkinson’s disease from southern Spain treatment with levodopa/carbidopa intestinal gel infusión [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/polyneuropathy-in-patients-with-parkinsons-disease-from-southern-spain-treatment-with-levodopacarbidopa-intestinal-gel-infusion/. Accessed November 24, 2024.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/polyneuropathy-in-patients-with-parkinsons-disease-from-southern-spain-treatment-with-levodopacarbidopa-intestinal-gel-infusion/