Intravenous levodopa or lisuride infusions can successfully reduce daily motor fluctuations in Parkinson's disease, which indicates adequate striatal dopaminergic mechanisms even in severe cases. In 3 patients who received continuous subcutaneous administration of lisuride, by means of a portable mini-infusion pump, in addition to oral levodopa plus decarboxylase inhibitor, mobility improved considerably and "off" periods were reduced or abolished. This response was maintained for 4 to 7 months without toxic side-effects, but increased dyskinetic movements were observed. All 3 patients were discharged and have been able to live independently during the months on treatment. These results suggest that continuous dopaminergic stimulation with the use of a portable delivery system can be a practical therapeutic tool in parkinsonian patients with complicated motor fluctuations.
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