Response of patients with postencephalitic Parkinsonism to levodopa

Thirty patients with postencephalitic Parkinsonism were treated with levodopa. In seven patients, treatment was withdrawn because of adverse reactions or insufficient benefit. Improvements observed in 26 patients who remained on treatment for a sufficient period to permit adequate assessment were comparable with those previously reported in Parkinson's disease. Some sequelae of encephalitis lethargica—notably, oculogyria and drooling—were appreciably improved in most patients affected, whereas choreoathetoid dyskinesias were aggravated by levodopa. Adventitious choreiform involuntary movements and behaviour disorders were the major side-effects. Patients with postencephalitic Parkinsonism may respond as well as patients with Parkinson's disease to levodopa but they develop both favourable responses and side-effects at a lower dosage and require careful dosage adjustments and close surveillance.