Abstract
We observed the change of levodopa effects on neurological symptoms related to kinds of common enteral feeding products in a Parkinson patient with a percutaneous endoscopic gastrostomy tube. The first feeding product did not change the resting tremor of extremities and rabbit syndrome. The second one increased these symptoms. Therefore, we replaced the second diet to the first diet and observed that these symptoms were returned to his previous condition. It was speculated that some contents of the enteral nutrient formula modified levodopa effects, thus we studied the changes of neurological symptom during three other feeding products in the patient. One of them worsened the symptoms in the patient and finally we found two feeding products which deteriorated the symptom in the patient. One of the two diets had high concentration of neutral amino acids and the other had rich dietary fibers. Large neutral amino acids and dietary fibers were reported to decrease the absorption of levodopa in the duodenum and the proximal jejunum. We should consider the concentration of large neutral amino acids and dietary fibers of enteral feeding products in a levodopa treated patient with Parkinson's disease.
