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On Tue 08 Feb, Chris van der Linden wrote: > As a neurologist and movement disorder specialist, treating 100's of > Parkinson patients, I fully agree. Most patients who are send to me for DBS > treatment are not well pharmacologically controlled and in many patients I > can adjust (read: increase levodopa) the medication, so that the quality off > life improves and surgery is (not yet) necessary or warranted. > > Chris van der Linden, M.D. > St. Lucas Hospital Ghent > Belgium > > > Hello Chris, I found your comments about under-dosed patients most interesting. Do you think that the major factor is really that the patient is not being tested frequently, or is it something more fundamental? My reason for asking is that among the many and varied symptoms displayed, I have begun to notice a significant number of PWPs with an interesting characteristic: When treated with levodopa, starting from zero, they show progressive benefit up to about the level that one may call 'normal'. As the level continues to increase however, these PWP s do not develop Dyskinesias as I would, -they just get sleepy! And as the levodopa level goes higher, they become almost comatose as long as the levodopa lasts. The trouble is that it is almost impossible to determine the optimum dose, and I often find them taking 1600 mg per day (Twice my level, and one memorable friend who chomped his way through 3000 mg/day. This is so different to the 'average PWP' I wondered if the symptoms were known to you? (Other symptoms which this group display are: No hand resting tremor: Main characteristic- stiff legs- patient has to resort to wheelchair at an early stage. Regards, -- Brian Collins <[log in to unmask]> (59/39/34)