Multiple System Atrophy is a progressive neurodegenerative disorder characterized by parkinsonism and autonomic dysfunction. Dysphagia and gastric dysmotility in advanced disease often compromise enteral medication absorption, limiting the effectiveness of standard oral or PEG-administered levodopa. We report a case of advanced MSA in which sublingual administration of co-beneldopa provided rapid and reliable relief from severe motor "off" episodes when enteral therapy failed. This novel approach bypassed gastrointestinal absorption, improved symptom control, and enhanced patient comfort in a palliative setting. Further research is warranted to evaluate the efficacy and safety of sublingual levodopa in similar contexts.
León et al. (Thu,) studied this question.
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