Breakthrough Parkinson's treatment at NNUH

Patients at the Norfolk and Norwich University Hospital who have the most severe problems with Parkinson's Disease are among the very first in the country to try a new technique that delivers medication directly into their abdomen.

Two patients at NNUH are now using a treatment called Duodopa T – a medication regime that only another seven patients in the whole country are currently receiving. The new technique involves a procedure to insert a tube through the abdomen and directly into the small bowel where the drug L-Dopa can be absorbed directly in gel form.

The symptoms of early Parkinson's disease can usually be well-controlled using medication in the form of tablets. However, in the later stages of Parkinson's disease, it can be difficult to control all the patient's symptoms consistently throughout the day using standard tablets alone. One of the reasons this is thought to happen is that medicines can get stuck in the stomach where they cannot be absorbed, and are not passed onto the small bowel quickly enough for them to be absorbed into the body.

As a result patients often fluctuate between a state of good, almost normal mobility, interspersed with sometimes uncontrollable involuntary movements which can cause falls and injury, and finally disabling stiffness and tremor. There is often no obvious pattern to these phases, and the unpredictability is one of the most disabling features for patients.

Consultant neurologist Dr Paul Worth said: “This treatment has only recently been licensed in this country but has been used successfully for many years in Sweden. Only around seven other patients in the UK have so far received this. We are lucky at NNUH to be one of the first hospitals in the country to use this treatment and that we have a multidisciplinary team of doctors and specialist nurses from neurology and gastroenterology who have the skill needed for this treatment. This is a very exciting development and represents a real hope for some extremely disabled patients with the condition.”

The NNUH team includes consultant neurologist Dr Paul Worth, neurological specialist nurses Rachael Rendell and Terri Johns, gastroenterologists Dr Ian Fellows and Dr Crawford Jamieson, and gastroenterology specialist nurse Judith McGovern.

It should be stressed that the treatment is only suitable for patients in whom all other measures have failed adequately to control symptoms, so only a very few are eligible. Two suitable patients have just been admitted to NNUH and will stay in hospital for around ten days. For the first week, a temporary tube is placed in their noses which passes down into the small bowel, and in this way, doctors can check that the treatment is going to be effective before placing a permanent tube through the abdominal wall.

Notes to editors
Parkinson's is a progressive neurological condition affecting movements such as walking, talking, and writing. In the UK it affects:

• around 120,000 individuals
• about 10,000 people in the UK are diagnosed each year statistically, men are slightly more likely to develop Parkinson's than women.