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7 Possible Causes for Variable Response to Levodopa Treatment

  • Perry Syndrome

    Perry syndrome is a rare atypical parkinsonism with depression, apathy, weight loss, and central hypoventilation caused by mutations in dynactin p150glued (DCTN1). A rare distal hereditary motor neuropathy, HMN7B, also has mutations in DCTN1. Perry syndrome has TAR DNA-binding protein of 43 kDa (TDP-43) inclusions[…][]

  • Striatonigral Degeneration

    Treatments used for Parkinson's disease are recommended. However, unlike Parkinson's disease, striatonigral degeneration is not responsive to levodopa.[] Treatment There is no cure for striatonigral degeneration, and treatments for the disorder have variable success.[]

  • 6-Pyruvoyl-Tetrahydropterin Synthase Deficiency

    Response to treatment is variable and the long-term and functional outcome is unknown.[] Treatment options include substitution with neurotransmitter precursors ( levodopa , 5-hydroxytryptophan ), monoamine oxidase inhibitors , and tetrahydrobiopterin . [2] Response[] Treatment options include substitution with neurotransmitter precursors (levodopa, 5-hydroxytryptophan), monoamine oxidase inhibitors, and tetrahydrobiopterin.[]

  • Neurodegeneration with Brain Iron Accumulation

    […] of parkinsonism (response to levodopa has been variable in this population) Treatment by a psychiatrist for those with significant neuropsychiatric symptoms Physical, occupational[] […] and spasticity, including consideration of oral baclofen, trihexyphenidyl, intramuscular botulinum toxin, and a trial of intrathecal baclofen if indicated Pharmacologic treatment[] […] obtained within the past two years Consultation with a clinical geneticist and/or genetic counselor Treatment of Manifestations The following are indicated: Pharmacologic treatment[]

  • Carbidopa-Levodopa

    With pharmacokinetic studies correlated to clinical ratings, plasma levodopa was less variable during Sinemet CR treatment, and clinical responses showed greater uniformity[] Compared to standard Sinemet 25/100, time to peak levodopa concentration (2.3 versus 1.1 hrs), onset of maximal clinical improvement (2.2 versus 1.1 hrs), and other indices[]

  • Levodopa

    Although levodopa remains the single most effective treatment for Parkinson's disease, treatment over a number of years may lead to variability in an individual's response[] […] to treatment—so-called “ motor fluctuations .”[] The fluctuating response to levodopa can be broadly pided into "on" and "off" periods.[]

  • Parkinson's Disease Type 9

    Schemes dividing Parkinson disease into bradykinesia vs tremor early vs later onset and good or poor response to levodopa treatment have all been proposed.[] Since Charcot, there have been numerous attempts to subdivide and make sense of the wide variability in clinical signs and symptoms in Parkinson disease.[]

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