 |
 |
(6) Department of Neurology, Tel-Aviv University Medical School, Tel-Aviv, Israel Abstract Parkinson’s disease (PD) is frequently regarded as a pure motor disorder. However, this degenerative illness affects also the autonomic as well as the enteric nervous systems. Impairment of gastric motility has been found in 70% of patients with PD. Neuropathological changes have been described in patients with PD in all parts of the nervous system responsible for gastric motility. Gastric motor dysfunction (delayed gastric emptying [GE]) is usually associated with early satiety, anorexia, abdominal fullness, nausea, and vomiting. Abnormalities in gastric myoelectric activity have been found in PD. Dysfunction of gastric motility may contribute to motor fluctuations in PD. Conversely, different medications used for the treatment of PD may exacerbate GE disturbances. Along with dopamine agonists, levodopa itself has been shown to slow gastrointestinal motility. Treatment of gastroparesis is usually problematic. Dietetic interventions, in combination with the use of prokinetic medications, are recommended. Gastrostomy or jejunostomy feeding tubes may also be considered. Jejunostomy, which provides the possibility of direct levodopa infusions into the intestine, may be preferable in fluctuating patients with PD. Data are not yet available on the use of gastric electrical stimulation in PD. To date, there is no satisfactory therapeutic approach to gastroparesis, and the clinician needs considerable creativity to help the patient with PD overcome this disabling syndrome and its consequences. ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn