PDMonitor case studies
The following case studies are taken from the Department of Neurology at the Sahlgrenska University Hospital, Göteborg, Sweden.
Case study 1
A 54-year-old man experiences some loss of balance during a tennis match. When this problem does not subside spontaneously, he visits a general practitioner. The doctor does not find anything abnormal, but refers him to a neurological department. Upon medical examination, the specialist suspects Parkinson’s disease.
A levodopa challenge is performed. The patient makes a baseline Motus test in a de novo, unmedicated state. An acute challenge of 200 mg dispersible levodopa is administered, and the test is performed again after one hour.
The results are compared using the summary report shown below.
Response summary for a levodopa challenge
The movement time is significantly reduced, due to an increase in simultaneity. Also, all the movement parts are slightly improved. A prescription of 150 mg (3 × 50 mg) levodopa is prescribed as a first-dose titration step.
Follow up test — 4 months after first visit
The patient is followed up after four months to evaluate the full effect of the current medication (150 mg levodopa). A further improvement in Movement Time, as well as improvement in all movement parts is noticed. The medication is now increased to 300 mg (3 × 100 mg) levodopa as the next titration step.
Summary of levodopa challenge plus follow-up
Follow-up test — 6 months after first visit
The patient is followed up again after six months. Further improvement is seen. The effect of treatment is documented by PDMonitor and controlled in the titration of medication.
Summary after follow-up
At the time of this follow-up, 10 mg (2 × 5 mg) of selegiline is added to the medication, in consultation with the patient.
Follow-up tests — up to 2.5 years after first visit
In subsequent follow-ups the dose of levodopa is increased to 450 mg (3 × 150 mg), in consultation with the patient about the progression of symptoms overall. No further improvement of the Movement Time is observed.
Summary of all tests up to 2.5 years from first visit