Levodopa-responsive retrocollis on the background of choreic dyskinesia

Int J Neurosci. 2020 May;130(5):461-463. doi: 10.1080/00207454.2019.1692836. Epub 2019 Dec 17.

Abstract

Purpose/aim: Retrocollis can substantially disturb the daily living of individuals with Parkinson's disease (PD). Clinician often encounter the difficulty in managing the retrocollis. Materials and Methods: We describe a patient with PD who presented with choreic dyskinesia and levodopa-responsive retrocollis. Results: The patient had dyskinesia and the off periods, and received levodopa (700 mg, 14 times/day). The patient received levodopa-carbidopa intestinal gel (LCIG) treatment. After several months, the patient complained of difficulty in swallowing and speech due to severe retrocollis. Thirty minutes following a fast levodopa infusion of LCIG, the retrocollis improved. As a result, a frontal view was obtained, and her talking abilities showed improvement. Conclusions: Severe retrocollis can be superimposed on choreic dyskinesia, and it was likely to increase during the off periods. Duodenal levodopa infusion may reduce the severity of retrocollis.

Keywords: LCIG; Parkinson; dyskinesia; motor complication; retrocollis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antiparkinson Agents / administration & dosage
  • Antiparkinson Agents / pharmacology*
  • Carbidopa / administration & dosage
  • Carbidopa / pharmacology*
  • Chorea / drug therapy*
  • Chorea / etiology
  • Drug Combinations
  • Female
  • Humans
  • Infusions, Parenteral
  • Levodopa / administration & dosage
  • Levodopa / pharmacology*
  • Parkinson Disease / complications
  • Parkinson Disease / drug therapy*
  • Torticollis / drug therapy*
  • Torticollis / etiology

Substances

  • Antiparkinson Agents
  • Drug Combinations
  • carbidopa, levodopa drug combination
  • Levodopa
  • Carbidopa