Blepharospasm as a Manifestation of Peak of Dose Dyskinesia in Parkinson Disease.

OBJECTIVES: The aim of the study was to report 4 patients with Parkinson disease (PD) and On-period blepharospasm (BS). METHODS: We analyzed patients with PD and motor fluctuations who developed BS in several different centers in Latin America. RESULTS: Four patients had BS while in the ON periods. CONCLUSIONS: Blepharospasm in the On period in patients with PD is extremely uncommon, and our series is the only one to describe such association.

Allergy to Carbidopa.

BACKGROUND: D-Decarboxylase inhibitors, such as carbidopa or benserazide, have been used as adjunct therapy in Parkinson disease shortly after levodopa synthesis in the 1960s. These compounds increase intracerebral drug concentration and decrease adverse effects by blocking peripheral conversion to dopamine. Skin rash as part of an allergic reaction was previously described in subjects who were using levodopa in combination with carbidopa or benserazide; however, etiology was never clear. Allergic reactions to carbidopa have not previously been reported. METHODS: We report a case of a 77-year-old woman with a diagnosis of idiopathic Parkinson disease, who developed autonomic and dermatological signs: conjunctival injection, rhinorrhea, excessive sweating, hypertension, and pruritic generalized rash, among others, immediately after carbidopa/levodopa administration regardless of the manufacturer. Treatment with dexamethasone combined with chloropyramine hydrochloride resulted in complete resolution of the hypersensitivity reaction each time it presented. The autonomic and dermatological manifestations did not reappear after treatment was replaced with benserazide/levodopa. CONCLUSIONS: To the best of our knowledge, this is the first case report of an allergic reaction specific to carbidopa. Our case highlights the importance of identifying the source of a hypersensitivity drug response, whether it is caused by the active component or by the excipients.

Effect of Levodopa + Carbidopa on the Laryngeal Electromyographic Pattern in Parkinson Disease.

BACKGROUND: Vocal impairment is one of the main debilitating symptoms of Parkinson disease (PD). The effect of levodopa on vocal function remains unclear. OBJECTIVE: This study aimed to determine the effect of levodopa on electromyographic patterns of the laryngeal muscle in patients with PD. STUDY DESIGN: This is a prospective interventional trial. METHODS: Nineteen patients with PD-diagnosed by laryngeal electromyography-were enrolled. Cricothyroid and thyroarytenoid (TA) muscle activities were measured at rest and during muscle contraction (phonation), when participants were on and off medication (12 hours after the last levodopa dose). RESULTS: Prevalence of resting hypertonia in the cricothyroid muscle was similar in the off and on states (7 of 19, P = 1.00). Eight patients off medication and four patients on medication had hypertonic TA muscle at rest (P = 0.289). No electromyographic alterations were observed during phonation for either medication states. CONCLUSION: Despite a tendency for increased rest tracings in the TA muscle when participants were on medication, no association was found between laryngeal electromyography findings and levodopa + carbidopa administration.

Lees' syndrome: a case series.

We report a case series of dopamine dysregulation syndrome, previously known as hedonistic homeostatic dysregulation in patients with Parkinson's disease on dopamine replacement therapies, now designated as Lees' syndrome.

Lees' syndrome: a case series / Síndrome de Lees: uma série de casos

We report a case series of dopamine dysregulation syndrome, previously known as hedonistic homeostatic dysregulation in patients with Parkinson's disease on dopamine replacement therapies, now designated as Lees' syndrome.

Relatamos uma série de casos da síndrome de desregulação dopaminérgica, previamente conhecida como desregulação homeostática hedonística em pacientes com doença de Parkinson em uso de terapia de reposição dopaminérgica, e agora definida como síndrome de Lees.

[Treatment of Parkinson's syndrome with a combination of levodopa and carbidopa]. / Tratamiento del síndrome de Parkinson con una combinación de levodopa y carbidopa.

It is widely known that administration of L-Dopa benefits patients with Parkinson's syndrome and combination of this drug with decarboxilase does it to a greater extent. In the present study 20 patients with Parkinson's syndrome received MK 486, a combination of L-Dopa and Carbidopa 10:1 (250 mg of the fomer and 25 mg of the latter). The aim of this study was to evaluate therapeutic activity of this drug combination. It was found that MK 486 is effective for controlling clinical manifestation in Parkinson's syndrome. Although side effects were seen frequently, they diminished or disappeared after time of drug administration.

[Treatment of Parkinson's disease with levodopa and a dopa decarboxylase inhibitor]. / Tratamiento de la enfermedad de Parkinson con levodopa y un inhibidor de la dopadescarvoxilasa

The combination of L-dopa with carbidopa was administered to 18 patients with ediopathic Parkinson's disease and the dose needed to control the manifestations, either partially or completely, with the least number of side effects, was established.