Many people with Parkinson's disease can control their symptoms with oral medication in the early stages. However, over time, some patients begin to notice that the medication's effects no longer last. Symptoms such as trembling hands, stiffness, slowed movement, or difficulty walking may recur before the next scheduled dose. As a result, patients must take medication more frequently and continue to experience periods of symptom relapse. Thanks to advances in neurology technology, levodopa infusion pump therapy is now available , which can help control symptoms in certain patients with advanced Parkinson's.
What is Advanced Stage Parkinson's?
Parkinson's is a neurodegenerative disease that occurs due to a reduction in nerve cells in the brain that produce dopamine , a substance that plays an important role in regulating body movements.
In the early stages, Parkinson's symptoms can generally be controlled with medication. However, in advanced Parkinson's , some patients begin to experience motor fluctuations , a condition where the medication's effects become unstable.
Patients may experience:
- Symptoms reappear before the next medication time ( wearing-off ).
- Uncontrolled body movements (dyskinesia) due to long-term use of levodopa in some patients.
- Difficulty walking or suddenly "freezing" while taking a step ( freezing of gait ).
- Daily activities are becoming increasingly disrupted even though you are taking medication regularly.
This condition does not mean that the drug is no longer working, but the body needs a more stable way of administering the drug.
What Is Levodopa Infusion Pump Therapy?
One innovation in the treatment of advanced Parkinson's is the levodopa infusion pump or Levodopa-Carbidopa Intestinal Gel (LCIG) .
Unlike oral medications, which are taken several times a day, this therapy delivers levodopa continuously using a small, portable infusion pump. The medication is delivered through a special tube connected to the small intestine, allowing for more consistent absorption.
Because drug levels in the body are more consistent, this therapy can help reduce the fluctuations in symptoms that often occur in advanced Parkinson's.
What are the Benefits of Levodopa Infusion Pump Therapy?
In patients who meet the criteria, levodopa infusion pump therapy can provide several benefits, including:
- Helps reduce the period when the drug is not working optimally ( off time ).
- Extend the time when body movement is better ( on time ).
- Helps reduce stiffness, trembling, and slowed movements.
- Reduces the need to take medication repeatedly in a day.
- Helps improve the independence and quality of life of patients in carrying out daily activities.
However, the benefits of therapy may vary from patient to patient and need to be evaluated periodically by a doctor.
Do All Parkinson's Patients Need This Therapy?
Levodopa infusion pumps are not first-line therapy and are not recommended for all Parkinson's patients . This therapy is generally considered for patients with advanced Parkinson's who are still responding to levodopa but experiencing fluctuating symptoms that are no longer optimally controlled with oral medication.
Before deciding on the use of this therapy, the doctor will conduct a thorough assessment, including the patient's health condition, ability to undergo the tube insertion procedure, and support from family or companions.
Consult a Neurologist
Technological advances have opened up more treatment options for people with advanced Parkinson's. One such option is a levodopa infusion pump, designed to deliver the medication continuously, helping to maintain symptom stability in patients who meet the indications.
If you or a family member has Parkinson's and begins to experience symptoms that are difficult to control despite regular medication, don't hesitate to consult a neurologist, particularly one who specializes in movement disorders (Parkinson's and Movement Disorders) . The doctor will conduct a thorough evaluation and explain whether levodopa infusion pump therapy is the right choice for your condition.
With proper treatment, many people with advanced Parkinson's can maintain a better quality of life and perform daily activities.
Article written by Dr. Gloria Tanjung, Sp.N (Neurology Specialist Doctor at EMC Alam Sutera & Sentul Hospital).