Foscarbidopa/foslevodopa, a 24-hour subcutaneous infusion of levodopa/carbidopa prodrugs, is approved for advanced Parkinson disease with motor fluctuations. Due to limited post-marketing data, the association between this novel formulation and related adverse events (AEs), particularly infusion-related or neurological complications, remains underexplored. This study aims to identify potential safety signals of foscarbidopa/foslevodopa-associated AEs using data mining of the FDA Adverse Event Reporting System (FAERS). To quantify safety risk signals of foscarbidopa/foslevodopa, disproportionality analyzes were conducted using the reporting odds ratio and Bayesian Confidence Propagation Neural Network methods, based on FAERS data from the last quarter of 2024 (2024Q4) to the second quarter of 2025 (2025Q2). Signal thresholds were strictly defined, and sensitivity analyses were performed to verify the robustness of results; subgroup analyses were conducted to explore sex differences and severity-related characteristics of AEs. The FAERS recorded 7527 foscarbidopa/foslevodopa-related AEs affecting 1914 patients. A total of 1616 patients experienced serious AEs, including 265 deaths. The most frequently reported AEs were on and off phenomenon (n = 223), fall (n = 195), hallucination (n = 156), and dyskinesia (n = 132). Potential safety signals were detected, such as on and off phenomenon, hallucination, and infusion site infection. Notably, FAERS data are subject to spontaneous reporting bias, missing information, and lack of denominator exposure data, so the above results only reflect statistical associations rather than definite causal relationships. FAERS data identify potential clinically significant associative AEs with foscarbidopa/foslevodopa, such as infusion site reactions and infections and hallucination. These findings support the need for enhanced monitoring of high-risk patients (e.g., mental and behavioral disorders, skin disorders) and reinforce the importance of real-world surveillance for novel Parkinson disease therapies. All findings are hypothesis-generating and require further clinical validation to confirm causal relationships.

We describe a 70-year-old man with no significant medical history who developed progressive left leg numbness, gait dysfunction, and recurrent falls. Within a year, he reported difficulty with both initiating steps and perceiving his left leg as his own. Neurologic evaluation revealed foot dystonia, bradykinesia, and plantar agraphesthesia. Electromyography and nerve conduction studies were unremarkable. Brain MRI demonstrated asymmetric parietal atrophy, greatest on the right. His symptoms did not improve with high-dose carbidopa-levodopa (900 mg/day). This case highlights plantar agraphesthesia as a valuable bedside sign of lower limb cortical sensory loss, even in the absence of hand involvement.

A 47-year-old woman with Parkinson disease (PD) complicated by severe motor fluctuations had been treated with deep brain stimulation (DBS) for 11 years and intestinal carbidopa/levodopa infusion for 5 years. Three months after her most recent clinic visit, at which both the DBS and infusion pump systems were confirmed to be functioning appropriately, she presented to the emergency department with abnormal movements. On examination, she had continuous, generalized, involuntary hyperkinetic movements with an erratic, dance-like quality, consistent with levodopa-associated dyskinesia. Evaluation revealed rhabdomyolysis, subcutaneous emphysema, and pneumomediastinum. She required admission to the intensive care unit for sedation and airway protection. After a key surgical intervention, she rapidly returned to her previous neurologic status and was discharged home. This case highlights the approach to acute dyskinesia and underscores the challenges of managing severe motor fluctuations in patients with PD.

Preeclampsia is a severe pregnancy hypertensive disorder characterized by arterial hypertension and multiorgan involvement, most frequently affecting the renal, hepatic, and neurological systems. While its typical manifestations include headaches, visual disturbances, and/or epigastric pain, atypical presentations may occur and may lead to life-threatening complications. We report the case of a 33-year-old multiparous woman who developed sudden left-sided hemiparesis, hemisensory loss, homonymous hemianopia, and rightward conjugate gaze deviation within 24 hours after a cesarean delivery. Blood pressure was 169/103 mmHg. Laboratory tests revealed moderate anemia, elevated LDH, low haptoglobin, and significant proteinuria (4.84 g/24h). Brain MRI demonstrated ischemic lesions in the right fronto-parieto-insular cortico-subcortical regions, consistent with a subacute infarction. The diagnosis of preeclampsia complicated by ischemic stroke was established. The patient was treated with acetylsalicylic acid, levetiracetam, and antihypertensive therapy (methyldopa and nicardipine). She progressively improved and achieved full neurological recovery within six weeks. Prophylaxis with low-dose aspirin and low molecular weight heparin was recommended for future pregnancies. This case highlights the importance of considering preeclampsia as a potential underlying cause of postpartum ischemic stroke. Early recognition of neurological symptoms and timely neuroimaging are critical to prevent severe maternal morbidity.

The coexistence of uterine fibroids and gestational hypertension (GH) presents a high-risk obstetric scenario associated with adverse maternal-fetal outcomes. We present the case of a 27-year-old primigravida diagnosed with a 22 × 28 mm anterior uterine fibroid at 8 weeks' gestation, which enlarged to 52 × 48 mm by 29 weeks. At 21 weeks' gestation, she developed new-onset GH (blood pressure 150/98 mmHg) without proteinuria. Her management included prophylactic low-dose aspirin (75 mg daily), methyldopa (250 mg twice daily), and structured home blood pressure monitoring. When her blood pressure rose to 155/100 mmHg at 34 weeks, the methyldopa dosage was increased to three times daily, which successfully restored control. Following induction of labor at 40 weeks, the patient had an uncomplicated vaginal delivery of a healthy 3.3 kg neonate with an APGAR score of 9. The postpartum course was unremarkable, and the fibroid regressed significantly. This case illustrated that a proactive, guideline-based strategy uniting early prophylaxis, adaptive pharmacotherapy guided by home monitoring, and anticipatory care can successfully navigate the compounded risks of this clinical dyad, leading to a favorable outcome.

Advanced Parkinson's disease (PD) is marked by motor fluctuations and dyskinesias that progressively lose responsiveness to optimized oral therapy, making continuous dopaminergic delivery an essential therapeutic strategy. This narrative review examines infusion-based treatments for advanced PD, focusing on their clinical rationale, efficacy, safety, and practical implementation. Currently available infusion therapies include continuous subcutaneous apomorphine infusion (CSAI), intrajejunal levodopa-carbidopa gel (LCIG), intrajejunal levodopa-carbidopa-entacapone gel (LECIG), and subcutaneous foslevodopa- -foscarbidopa (LDp/CDp) infusion. These modalities provide more continuous dopaminergic stimulation than oral therapy, substantially reducing daily OFF time and increasing ON time without disabling dyskinesias, thereby improving quality of life (QoL). Their use may, however, be limited by adverse effects (AEs), including infusion-site reactions (ISR) (CSAI, LDp/CDp), the risk of hallucinations with LDp/CDp, and their invasive nature, as well as potential device-related complications or polyneuropathy associated with LCIG. Levodopa-carbidopa-entacapone gel offers improved levodopa bioavailability and a more user- -friendly device design compared with LCIG. A fully subcutaneous levodopa-carbidopa (LD/CD) infusion (ND0612) is also under investigation, with preliminary results suggesting acceptable safety-to-adverse-events risk ratio and clinical benefit. Despite increasing availability of infusion therapies in recent years, their utilization in clinical practice remains markedly lower than the estimated proportion of eligible patients, underscoring persistent systemic barriers. Further efforts aimed at optimizing qualification pathways, decentralizing access, and enhancing the integration of device-aided therapies (DAT) into routine advanced PD management are warranted.