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Brain calcification in a CSF1R mutation carrier precedes white matter degeneration

reported that more than 20% of PD patients complain of nausea or abdominal bloating and, furthermore, that gastric emptying is delayed even in PD patients with mild symptoms compared with healthy controls. Here we report a case of cascade stomach causing failure of levodopa absorption. It has been reported that a slight bending of the body is sufficient to eliminate a gastric cascade, and in the present study bending forward after taking levodopa led to improvement in levodopa absorption. Cascade stomach is a congenital or acquired functional deformity of the stomach and has been reported in approximately 15% of the Japanese population. It can be presumed that cascade stomach is not uncommon, even in patients with PD. Cascade stomach should therefore be taken into account as a potential factor causing delayed-on and no-on phenomena.