Levodopa/carbidopa

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Biphasic freezing of gait and worsening dyskinesias: case report A 70-year-old man developed biphasic freezing of gait during treatment with levodopa/carbidopa for Parkinson’s disease. He further experienced worsening of dyskinesias after increasing the dose of levodopa/carbidopa. The man presented with disabling freezing of gait. He had a history of Parkinson’s disease and had been receiving treatment with tablet levodopa/carbidopa 100mg/25mg five times daily. Before the first dose of levodopa/carbidopa, he had not experienced freezing of gait. However, he reported development of freezing of gait after the first morning dose of levodopa/carbidopa; he could not initiate walking in spite of the desire and intention to walk. He also reported that the freezing of gait resolved after the second dose of levodopa/carbidopa. He was video-taped for gait assessment while being off levodopa/carbidopa for over 12 hrs after the last intake. He showed hypokinetic gait, but no freezing of gait. However, 15 min after administration of levodopa/carbidopa 100mg/25mg, he developed freezing of gait with attempted stepping. He reported capability of walking, but being unable to do it episodically. He then received an extra dose of levodopa/carbidopa 200mg/50mg and was able to walk faster with longer steps, without freezing of gait. The dose of levodopa/carbidopa was increased to 150mg/37.5mg five times daily, resulting in a decrease in the freezing of gait. However, the higher dose of levodopa/carbidopa led to worsening of dyskinesias, which was treated with amantadine. His biphasic freezing of gait was considered secondary to levodopa [not all outcomes stated]. Nonnekes J, et al. Biphasic Levodopa-Induced Freezing of Gait in Parkinson’s Disease. Journal of Parkinson’s Disease 10: 1245-1248, No. 3, Jul 2020. Available from: URL: 803500537 http://doi.org/10.3233/JPD-201997

0114-9954/20/1821-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved

Reactions 12 Sep 2020 No. 1821

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