[Skip to Content]
[Skip to Content Landing]
January 1979

Parkinsonism With 'On-Off' PhenomenaIntravenous Treatment With Levodopa After Major Abdominal Surgery

Author Affiliations

From the Experimental Therapeutics Branch, IRP, National Institute of Neurological and Communicative Disorders and Stroke (Drs Rosin and Calne and Ms Eng), and the National Cancer Institute (Dr Devereux), Bethesda, Md.

Arch Neurol. 1979;36(1):32-34. doi:10.1001/archneur.1979.00500370062014

• Continuous intravenous infusion of levodopa was used for eight days to manage a parkinsonian patient with "on-off" fluctuations who underwent abdominoperineal resection for carcinoma of the rectum. Reasonable control of parkinsonism was obtained initially with small doses of levodopa, but more than 4 g daily were eventually required. No adverse effects on cardiac rhythm, blood pressure, or gastrointestinal function occurred. Frequent adjustment of levodopa dosage was necessary in view of continuing "on-off" fluctuations. Severe akinesia, which can cause dysphagia, respiratory complications, and venous stasis in the legs, can benefit from this method of management after major abdominal surgery in a patient with advanced parkinsonism.