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NEUROLOGY 1986;36:100
© 1986 American Academy of Neurology

Episodic unresponsiveness to single doses of L-dopa in parkinsonian fluctuators

Eldad Melamed, MD, Victor Bitton, MD and Orly Zelig, MD

Laboratory of Clinical Neurochemistry, Department of Neurology, Hadassah University Hospital, Jerusalem, Israel.

Episodic total unresponsiveness to single doses of L-dopa developed in 14 of 32 parkinsonians with declining efficacy and response fluctuations after chronic L-dopa therapy. Complete lack of clinical benefit after occasional doses was unpredictable, occurred at least once daily mostly in the afternoon, and differed from other response failures related to food intake. In two patients, total unresponsiveness after dose ingestion coincided with lack of increases in plasma L-dopa levels suggesting that phenomenon was due, in part, to failure of L-dopa absorption from the gut.

Address correspondence and reprint requests to Dr. Melamed, Laboratory of Clinical Neurochemistry, Department of Neurology, Hadassah University Hospital, Jerusalem, P.O. Box 12000, Israel.

Supported in part by the American Parkinson's Disease Association and by the Lena P. Harvey Endowment Fund for Neurological Research.

Accepted for publication May 17, 1985.




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