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  • Levodopa-carbidopa related severe mixed dyskinesia in a patient with advanced Parkinson’s disease admitted to the intensive care unit

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Critical care
Levodopa-carbidopa related severe mixed dyskinesia in a patient with advanced Parkinson’s disease admitted to the intensive care unit
  1. Mahsa Movahedan1,
  2. Kieran Shah2 and
  3. Robert McDermid2
  1. 1Critical Care, St Paul’s Hospital, Vancouver, British Columbia, Canada
  2. 2Surrey Memorial Hospital, Surrey, British Columbia, Canada
  1. Correspondence to Dr Mahsa Movahedan; mmovahedan{at}providencehealth.bc.ca

Abstract

Parkinson’s disease (PD) is characterised by motor complications that can become difficult to manage with disease progression. Certain medications used to treat PD, such as levodopa-carbidopa, can also cause motor complications. The timing and type of motor complication occurrence can provide important clues in determining the cause and help with treatment optimisation.

This case report highlights the management of severe mixed dyskinesia in a critically ill PD patient admitted to the intensive care unit (ICU). The patient experienced debilitating motor complications, requiring intensive monitoring and personalised levodopa-carbidopa dose adjustments. Following the optimisation of her regimen, which included increasing the frequency of lower doses and the addition of another agent, her motor complications improved. This report underscores the need for individualised treatment strategies in advanced PD and the benefit of ICU-level close monitoring to optimise PD therapy in patients with severe dyskinesias.

  • Parkinson's disease
  • Intensive care

https://doi.org/10.1136/bcr-2024-264300

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    Footnotes

    • Contributors All authors contributed substantially to the conception, design and acquisition of patent data, drafting the article and revising it critcally for important intellectual content. All authors approved the final version of the case report and agreed to be accountable for all aspects of the work. MM is the guarantor of the work. We disclose that OpenAI’s ChatGPT (OpenAI, ChatGPT (April 2024 version)) language tool was used in writing small sections of this manuscript. ChatGPT usage aimed to ensure clarity and coherence of the language and perform grammatical checks to improve overall readability.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.