Rescue Levodopa/Carbidopa Intestinal Gel for Secondary Deep Brain Stimulation Failure

OBJECTIVE: The long-term efficacy of deep brain stimulation (DBS) for motor fluctuations in advanced Parkinson's disease (PD) has been well established; however, motor fluctuations may recur over time despite multiple adjustments of DBS settings and medications. METHODS: We conducted a retrospective chart review of three patients for whom levodopa-carbidopa intestinal gel (LCIG) was additionally administered as a rescue therapy for secondary DBS failure due to the recurrence of motor fluctuations. RESULTS: The three patients had advanced PD with a disease duration of 14-19 years, and had undergone DBS for motor fluctuations refractory to standard medical management. LCIG was administered to the patients because of symptom recurrence years after DBS and provided complementary effects in all patients. CONCLUSION: The cases presented here show that rescue LCIG therapy may be a complementary treatment option for patients with post-DBS advanced PD who have a recurrence of troublesome motor complications.