Comment gérer un traitement par Duodopa® dans la maladie de Parkinson évoluée ?

Parkinson's disease (PD) is a severe and frequent neurodegenerative disorder affecting about 1 million people worldwide. Duodopa® is an intra-duodenojejunal infusion of levodopa which allowed continuous dopaminergic stimulation. More than one hundred patients have been treated in France, and about 3000 in Europe. In France, this treatment is reserved for very advanced PD patients with severe motor fluctuations, contra-indication for STN DBS or apomorphine or after loss of efficacy. Here, we review the practical use of this treatment, the main results in terms of efficacy and adverse events, and the way to prevent them.