The Townsville Hospital (TTH) neurology, gastroenterology, and radiology specialists have collaborated to pioneer levodopa carbidopa intestinal gel (levodopa) via percutaneous endoscopic gastrostomy (PEG) as a treatment pathway for patients with late-stage Parkinson’s disease. TTH is the first non-metropolitan hospital in Australia to offer this treatment; it is also currently the largest centre for levodopa infusion outside Sydney.
In established Parkinson’s neurologists use oral levodopa, a chemical building-block that replaces the dopamine lost in Parkinson's patients resulting in the involuntary shaking that characterises the disease. As Parkinson’s progresses, the brain needs more levodopa as its effect becomes increasingly shorter. Levodopa infusion involves the endoscopist making a hole in the abdomen to insert a tube and threading a small catheter through the stomach into the jejunum to continually infuse the levodopa at a steady rate. Infusion of levodopa through the bloodstream significantly reduces the severe involuntary movements of advanced disease including stiffness, shaking, and ‘freezing’ (patient is stuck to the spot). This minimally invasive treatment is optimal for patients for whom deep brain stimulation, including patients who are elderly, vulnerable, or have dementia, is not a possibility.