Síndrome de Parkinson e L-dopa

Pompeu, Fernando; Sztajnberg, Maier; Teixeira, Ivan; Carneiro, Sérgio; Schulz, Israel; Ribeiro, Sérgio; Vasconcelos, Hélder; Albuquerque, Edimar

doi:10.1590/S0004-282X1971000200005

Resumos

Os autores assinalam o efeito favorável da L-Dopa no tratamento da síndrome parkinsoniana, apresentados por 25 pacientes. Tecem considerações sobre os efeitos colaterais e resultados terapêuticos. Assinalam a presença de eosinofilia após o tratamento em alguns casos e chamam a atenção sobre dois casos que tiveram crises convulsivas durante o tratamento.

Encouraged by the recent literature on the subject, the authors decided to treat 18 patients in double-blind fashion using L-Dopa against a placebo during 4 weeks. Dosage was gradually increased from 0,5 g to 4 g within this four-week period. Afterwards the trial proceeded openly, all patients receiving L-Dopa. Further 7 patients were added, making up a total number of 25. The trial was carried on for further 8 weeks. Blood counts, liver function tests, urinalysis, ECG and EEG were performed. Eosinophilia, of which the origin could not be ascertained, was found in 8 cases, and generalised convulsions ocurred in two cases. By the 8th week of treatment 6 patients showed marked improvement; 12 had improved noticeably, and the remaining 7 were slightly better. Hyperkinesia and postural hypotension were controlled by dosage reduction. Four patients reported increase of sexual activity. The trial proceeds, a clinical reappraisal being foreseen for the 12th month of. treatment.

Síndrome de Parkinson e L-dopa

Treatment of parkinsonism with L-Dopa

Fernando Pompeu^I; Maier Sztajnberg^II; Ivan Teixeira^III; Sérgio Carneiro^II; Israel Schulz^II; Sérgio Ribeiro^II; Hélder Vasconcelos^IV; Edimar Albuquerque^V

^IServiço de Neurologia do Hospital Estadual Miguel Couto (Guanabara): Chefe do Serviço

^IIServiço de Neurologia do Hospital Estadual Miguel Couto (Guanabara): Assistentes

^IIIServiço de Neurologia do Hospital Estadual Miguel Couto (Guanabara): Chefe de Clínica

^IVServiço de Neurologia do Hospital Estadual Miguel Couto (Guanabara): Médico-estagiário

^VServiço de Neurologia do Hospital Estadual Miguel Couto (Guanabara): Acadêmico

RESUMO

Os autores assinalam o efeito favorável da L-Dopa no tratamento da síndrome parkinsoniana, apresentados por 25 pacientes. Tecem considerações sobre os efeitos colaterais e resultados terapêuticos. Assinalam a presença de eosinofilia após o tratamento em alguns casos e chamam a atenção sobre dois casos que tiveram crises convulsivas durante o tratamento.

SUMMARY

Encouraged by the recent literature on the subject, the authors decided to treat 18 patients in double-blind fashion using L-Dopa against a placebo during 4 weeks. Dosage was gradually increased from 0,5 g to 4 g within this four-week period. Afterwards the trial proceeded openly, all patients receiving L-Dopa. Further 7 patients were added, making up a total number of 25. The trial was carried on for further 8 weeks. Blood counts, liver function tests, urinalysis, ECG and EEG were performed. Eosinophilia, of which the origin could not be ascertained, was found in 8 cases, and generalised convulsions ocurred in two cases. By the 8^th week of treatment 6 patients showed marked improvement; 12 had improved noticeably, and the remaining 7 were slightly better. Hyperkinesia and postural hypotension were controlled by dosage reduction. Four patients reported increase of sexual activity. The trial proceeds, a clinical reappraisal being foreseen for the 12^th month of. treatment.

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Serviço de Neurologia Hospital Estadual Miguel Couto Rua Mário Ribeiro s/n.º, Gávea Rio de Janeiro, GB Brasil

Trabalho do Serviço de Neurologia do Hospital Estadual Miguel Couto (Guanabara) apresentado no IV Congresso Brasileiro de Neurologia (julho de 1970, Porto Alegre, RS).

1. CALNE, D. B.; STERN, G. M.; LAURENCE, D. R.; SHARKEY, J. & ARMITAGE, P. L-Dopa in postencephalitic parkinsonism. Lancet 1:744, 1969.
2. CALNE, D. B.; STERN, G. M.; SPIERS, A. S. D. & LAURENCE, D. R. L-Dopa in idiopathic parkinsonism. Lancet nov. 8:973, 1969.
3. CALNE, D. B.; BRENNAN, J.; SPIERS, A. S. D. & STERN, G. M. Hypotension caused by L-Dopa. Brit. Med. J. 1:474, 1970.
4. COTZIAS, G. C.; PAPAVASILIOU, P. S. & GELLENE, R. Modification of parkinsonism. Chronic treatment with L-Dopa. New Engl. J. Med. 280:337, 1969.
5. COTZIAS, G. C. L-Dopa in Parkinson's Disease. Hospital Practice 4:35-41, 1969.
6. DUVOISIN, R.; BANETT, R.; SCHEAR, M.; HOEHN, M. & YAHR, M. The use of L-Dopa in parkinsonism. Third Symposium in Parkinson's Disease (May 1968). Livingstone, Edinburgh, 1969, págs. 185-192.
7. FASANO, V. A.; URCIUDI, R. ; BROGGI, G. & CANNELLA, M. II Levodopa nel tratamento del morbo di Parkinson. Minerva Méd. 60:473, 1969.
8. FRIEDHOFF, A. J.; HEKIMIAN, L.; ALPERT, M. & TOBACH, E. Dihydroxyphenylalanine in extra-piramidal diseases. J.A.M.A. 184:285, 1963.
9. GODWIN-AUSTEN, R. B.; TOMLINSON, E. B.; FREARS, C. C. & KOK, H. W. L. Effects of L-Dopa in Parkinson's Disease. The Lancet 26:165, 1969.
10. GREENBERG, J. L-Dopa too sucessfull. New Engl. J. Med. 281:621, 1969.
11. JOHANSSON, B.; OLSSON, R.; STEG, G. & SVANBORG, A. Side effects during treatment with L-Dopa in parkinsonism. IX International Congress of Neurology (New York Seembro 1969). Resumo em Excerpta Med. Intern. Cong. Series, n.° 193, pág. 171, 1969.
12. KLAWANS, H. L. & ERLICH, M. L-Dopa and the negative simptoms of parkinsonism. J. Neurol. Neurosurg. Psychiat. 33:460, 1969.
13. MAWDSLEY, C. Treatment of parkinsonism with laevodopa. Brit. Med. J. 1:331, 1970.
14. O'REILLY, S. L-Dopa in Parkinson's disease. Lancet 1:984, 1969.
15. POZA, M. & ZAMARRON, M. Parkinson y L-Dopa. Cienc. Neurol. (Espanha) 3:abril-junio, 1969.
16. ROSEMBERG, H. L-Dopa in Parkinson's Disease. New England. J. Med. 280: 730, 1969.
17. YAHR, M. D.; DUVOISIN, R. C.; SCHEAR, M. J.; BARRET, R. E. & HOEHN, M. M. Treatment of parkinsonism with laevodopa. Arch. Neurol. (Chicago) 21:343, 1969.

Datas de Publicação

Publicação nesta coleção
19 Abr 2013
Data do Fascículo
Jun 1971

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. CALNE, D. B.; STERN, G. M.; LAURENCE, D. R.; SHARKEY, J. & ARMITAGE, P. L-Dopa in postencephalitic parkinsonism. Lancet 1:744, 1969.

[2] 2. CALNE, D. B.; STERN, G. M.; SPIERS, A. S. D. & LAURENCE, D. R. L-Dopa in idiopathic parkinsonism. Lancet nov. 8:973, 1969.

[3] 3. CALNE, D. B.; BRENNAN, J.; SPIERS, A. S. D. & STERN, G. M. Hypotension caused by L-Dopa. Brit. Med. J. 1:474, 1970.

[4] 4. COTZIAS, G. C.; PAPAVASILIOU, P. S. & GELLENE, R. Modification of parkinsonism. Chronic treatment with L-Dopa. New Engl. J. Med. 280:337, 1969.

[5] 5. COTZIAS, G. C. L-Dopa in Parkinson's Disease. Hospital Practice 4:35-41, 1969.

[6] 6. DUVOISIN, R.; BANETT, R.; SCHEAR, M.; HOEHN, M. & YAHR, M. The use of L-Dopa in parkinsonism. Third Symposium in Parkinson's Disease (May 1968). Livingstone, Edinburgh, 1969, págs. 185-192.

[7] 7. FASANO, V. A.; URCIUDI, R. ; BROGGI, G. & CANNELLA, M. II Levodopa nel tratamento del morbo di Parkinson. Minerva Méd. 60:473, 1969.

[8] 8. FRIEDHOFF, A. J.; HEKIMIAN, L.; ALPERT, M. & TOBACH, E. Dihydroxyphenylalanine in extra-piramidal diseases. J.A.M.A. 184:285, 1963.

[9] 9. GODWIN-AUSTEN, R. B.; TOMLINSON, E. B.; FREARS, C. C. & KOK, H. W. L. Effects of L-Dopa in Parkinson's Disease. The Lancet 26:165, 1969.

[10] 10. GREENBERG, J. L-Dopa too sucessfull. New Engl. J. Med. 281:621, 1969.

[11] 11. JOHANSSON, B.; OLSSON, R.; STEG, G. & SVANBORG, A. Side effects during treatment with L-Dopa in parkinsonism. IX International Congress of Neurology (New York Seembro 1969). Resumo em Excerpta Med. Intern. Cong. Series, n.° 193, pág. 171, 1969.

[12] 12. KLAWANS, H. L. & ERLICH, M. L-Dopa and the negative simptoms of parkinsonism. J. Neurol. Neurosurg. Psychiat. 33:460, 1969.

[13] 13. MAWDSLEY, C. Treatment of parkinsonism with laevodopa. Brit. Med. J. 1:331, 1970.

[14] 14. O'REILLY, S. L-Dopa in Parkinson's disease. Lancet 1:984, 1969.

[15] 15. POZA, M. & ZAMARRON, M. Parkinson y L-Dopa. Cienc. Neurol. (Espanha) 3:abril-junio, 1969.

[16] 16. ROSEMBERG, H. L-Dopa in Parkinson's Disease. New England. J. Med. 280: 730, 1969.

[17] 17. YAHR, M. D.; DUVOISIN, R. C.; SCHEAR, M. J.; BARRET, R. E. & HOEHN, M. M. Treatment of parkinsonism with laevodopa. Arch. Neurol. (Chicago) 21:343, 1969.