Treating Idiopathic Parkinson’s Disease with Bonoesikpungjigyeong-tang : A Case Study on “Delayed On” and “Wearing Off” Phenomena after Long-term Levodopa Intake

Abstract

A 69-year-old female diagnosed with idiopathic Parkinson’s disease and treated with anti-Parkinsonian medications, including levodopa, for 7 years presented with complaints of wearing-off phenomenon and delayed onset of medication efficacy, resulting in postural instability and feeling of severe exhaustion. The patient underwent a 50-day course of treatment with Bonoesikpungjigyeong-tang formula. The effects of the treatment were evaluated by recording the average time to onset of medication efficacy, the average time to medication wearing-off, and discomfort due to wearing-off phenomenon. Postural instability was assessed using the Numeric Rating Scale (NRS). The patient’s overall quality of life was assessed using the EQ-5D-3L. After 50 days of treatment, the average time to onset of medication efficacy decreased, and the average time to medication wearing-off increased. Discomfort due to wearing-off phenomenon and postural instability decreased. This case suggests that Bonoesikpungjigyeong-tang might be an alternative for improving discomfort caused by long-term levodopa intake.