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Andreia Ferreira, MD, Braga Hospital, Braga, Portugal, discusses the use of levodopa intestinal gel as a symptomatic treatment for multiple system atrophy (MSA), a condition that lacks a standard treatment. Dr Ferreira shares a case of a patient with MSA who experienced autonomic symptoms and later developed respiratory symptoms. The patient was initially treated with levodopa medication, but the symptoms persisted, leading to the introduction of levodopa intestinal gel. This palliative measure significantly improved the patient’s symptoms, leading to a better quality of life and increased functionality. Although there is limited literature on this approach, Dr Ferreira suggests that exploring alternative treatments like intestinal levodopa gel may benefit MSA patients. This interview took place at the 2023 International Congress of Parkinson’s Disease and Movement Disorders in Copenhagen, Denmark. These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.