한국인 뇌염후성 파킨소니즘에 대한 L-Dopa 치료에 관한연구

Abstract

[한글]

[영문]

In these 10years accumulating evidences have suggested that dopamine, a catecholamine precursor of adrenaline and noradrenaline is present in particulary high concentration in the corpus striatum and that the amount of dopamine in the basal ganglia of parkinsonism patients is reduced. It has been suggested that Parkinson's syndrom might result from an imbalance between cholinergic-excitatory and dopaminergic-inhibitory actions in the direction of cholinergic dominance.

On this theoretical basis attempts have been made to treat parkinsonism by raising the level of dopamine in the brain. Early clinical studies of the therapeutic value of L-dopa produced conflicting results. Recent accounts indicated that L-dopa, in a daily dose of 8 grm, produce compatible therapeutic effects with

less risk of provoking side effects.

In the present study maximum tolerated doses of L-dopa were give to a group of Korean patients who had been severely disabled by postencephalitic parkisonism. The age of patients ranged from 5 to 19 years, mean age 9.6 years. In addition to parkinsonism, 3 patients had epileptic seizures; 1 grand-mal type and 2 psychomotor type. The duration of their illness ranged from 3 to 11 years.

Prior to the study all patients were screened clinically and biochemically for evidence of cardiovascular, hepatic and renal disease. Clinical evaluations were done every week and all laboratory studies were done every two weeks. L-dopq was orally administered, in a divided dose, three times a day with meals. The dose was increased every 3rd or 4th day until the maximum tolerated dose was attained. After two week of L-dopa administration in highly effective doses, the dose was reduced

gradually. L-dopa was administered continuously for a period of 82 to 112 days. Each item of Webster Rating 3 Point Scale was scored according to severity by three neuropsychiatry dose of L-dopa administered.

3. In 3 epileptics the frequency of epileptic episode was markedly reduced or controlled during the L-dopa therapy with highly effective dose.

4. In comparison with adult parkinsonian patients, the child or adolescent case of postencephalitic parkinsonism responded with larger doses of L-dopa.