An Observational Study on the Effect of Levodopa/Carbidopa on Parkinsonian Features of X- Linked Dystonia Parkinsonism after Pallidal Stimulation

BACKGROUND The estimated record of XDP patients in the Philippines is 1 in 322,000 with highest prevalence in Capiz of 1 in 4,000 among male population. Levodopa/Carbidopa is used widely to XDP that provides pharmacologic treatment used in dystonia both as diagnostic and therapeutic. It’s availability and cost readily make this available for patients with XDP. OBJECTIVE To date, there has not been any available data regarding the effect of levodopa/carbidopa to parkinsonian features after DBS to XDP patients hence the investigators looked into its effects as well as describe the demographic characteristics of the chosen population. METHODS This study is a retrospective descriptive-analytical study. The authors used purposive sampling in choosing participants in the study considering the limitation of the desired population; rarity of XDP and the few XDP patients who underwent DBS. The participants included the patients in a single-center movement disorder clinic who were eligible upon the basis of the inclusion criteria. Parkinsonian symptoms were graded using the MDS-UPDRS part III (motor section) by reviewing the videos of the participants before and after levodopa/carbidopa administration. RESULTS There were 26 total participants included in this study. The mean age was 41. The most common initial presentation among them was cervical dystonia 50% (N=13/26), the median age for onset of parkinsonism to develop post DBS was 3 months to which the most common feature were tremor 31% and rigidity 31%. There is a significant difference p<.001 in the parkinsonian features pre and post levodopa/carbidopa administration. CONCLUSION Levodopa/Carbidopa offers a promising effect on the parkinsonian symptom among XDP patients after pallidal stimulation.