抄録
In order to confirm beneficial effects of L-Dopa on Parkinson's syndrome and to know an optimal dosage of the drug in Japanese, thirty-one patients with Parkinsonism were treated with L-Dopa. In thirteen cases of these patients, clinical evaluation was performed by use of cross-over double blind method. The optimal dose in Japanese ranged from 1 to 5.25 g. daily, with the average 3.39 g., which was considerably smaller than that used in U. S. A. or in Europe. In preliminary study, overall improvement was observed in 82.7% of patients, and L-Dopa was highly effective in every clinical feature which was evaluated, namely, rigidity, tremor and impairment in blinking, facial expression, speech, elevation of arms, gait and arm swing. Rate of improvement in tremor by the drug was almost same as that in rigidity. Significant improvement was observed in counting test, peg-board test, and steps and time required to walk ten meters.
Effects of L-Dopa on the following features were dose dependent: rigidity and tremor of upper extremities, arm swing, peg-board test, and steps and time required for walking ten meters. Cross-over double blind test revealed significant improvement in rigidity of both upper and lower extremities and arm swing as well as global judgement. Side effects encountered consisted of nausea, anorexia, vomiting, involuntary movements and visual hallucination. Nausea was the chief dose-limiting side effect, but involuntary movement was less frequent. It was concluded that L-Dopa appears to be effective for Parkinsonism with smaller dosage in Japanese than that in Occidentals.
