[Parkinson disease--problems in long-term treatment. Dopamine agonists optimize L-dopa therapy]

In a 59-year-old male with a 10 year history of Parkinson's disease, progressive movement disorders occurred under medical treatment (end-of-dose akinesia and peak-dose dyskinesia). Thereupon his treatment was changed to a combination of L-dopa/ decarboxylase inhibitor administered during the day in 5 fractions, and additionally a slow-release dopa preparation given on retiring for the night. At the same time, the patient received the dopamine agonist lisuride. While the patient was hospitalized for surgery, his anti-parkinsonism regimen was initially stopped and then continued in changed form. In the following weeks he experienced a drastic impairment of mobility and, in particular, suffered pronounced nocturnal hypokinetic events. A second period of hospitalization became necessary, a complex medical therapeutic regimen similar to the previously successful combination was established. This resulted in satisfactory mobility, and the patient was able to go back to work.