Acute/subacute demyelinating polyneuropathy in Parkinson’s Disease patients on levodopa-carbidopa intestinal gel therapy: systematic review with new case report

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Abstract

Polyneuropathy (PNP) is a known complication of levodopa-carbidopa intestinal gel (LCIG) therapy of advanced Parkinson’s Disease (PD). The overall prevalence of PNP in PD is estimated to be 42.1% (as shown in a review by Romagnolo et al. 2018), and the most common type is chronic axonal polyneuropathy. There is a group of acute/subacute onset demyelinating polyneuropathies, which is far less common, although it seems to be an important factor leading to the rapid discontinuation of LCIG treatment. In this systematic review, we present data on demyelinating polyneuropathy with acute/subacute onset; we identified nine papers including prospective assessments and case reports, with detailed information on 15 patients. In all patients, despite treatment with corticosteroids, intravenous immunoglobulins (IVIG) or plasma exchange (PE), the LCIG therapy was terminated. We also present a case of subacute demyelinating polyneuropathy with effective treatment and continuation of LCIG therapy.

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Piekarski, R., Roszmann, A., Dulski, J., & Sławek, J. (2023). Acute/subacute demyelinating polyneuropathy in Parkinson’s Disease patients on levodopa-carbidopa intestinal gel therapy: systematic review with new case report. Neurologia i Neurochirurgia Polska. Via Medica. https://doi.org/10.5603/PJNNS.a2023.0001

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