Continuous subcutaneous apomorphine infusion (CSAI) is, at present, an alternative option for advanced Parkinson's disease (PD) with motor fluctuations. We studied the evolution of patients with PD and severe motor fluctuations long-term treated with CSAI. We reviewed data from 82 patients with PD (mean age, 67 +/- 11.07; disease duration, 14.39 +/- 5.7 years) and severe motor fluctuations referred to 35 tertiary hospitals in Spain. These patients were long-term treated (for at least 3 months) with CSAI and tolerated the procedure without serious side effects. We compared the baseline data of these 82 patients (before CSAI) with those obtained from the last follow-up visit of each patient. The mean follow-up of CSAI was 19.93 +/- 16.3 months. Mean daily dose of CSAI was 72.00 +/- 21.38 mg run over 14.05 +/- 1.81 hours. We found a statistically significant reduction in off-hours, according to self-scoring diaries (6.64 +/- 3.09 vs. 1.36 +/- 1.42 hours/day, P < 0.0001), total and motor UPDRS scores (P < 0.0001), dyskinesia severity (P < 0.0006), and equivalent dose of antiparkinsonian therapy (1,405 +/- 536.7 vs. 800.1 +/- 472.9 mg of levodopa equivalent units P < 0.0001). CSAI is an effective option for patients with PD and severe fluctuations, poorly controlled by conventional oral drug treatment.

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La degeneración corticobasal (DCB) es una rara y compleja enfermedad neurodegenerativa perteneciente a las taupatías 4R. El síndrome corticobasal (SCB) es uno de los fenotipos clínicos asociado con la patología DCB y se manifiesta como un síndrome rígido-acinético asimétrico con pobre respuesta a levodopa junto con clínica de disfunción cortical. Sin embargo, el SCB puede ser la manifestación de otras patologías neurodegenerativas y a su vez la DCB puede manifestarse con distintos fenotipos clínicos. La diversidad clínica, el mimetismo con otras patologías no-DCB y la ausencia de biomarcadores hacen difícil su diagnóstico ante mortem. En la actualidad, las opciones terapéuticas para la DCB siguen siendo sintomáticas.