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Dear Larry , The fact that your brother's tremor responds to Sinemet tells me that he has a brain syndrome that includes damage to the substantia nigra. but the other more devastatimg symptoms lead me to believe he has what neurologists call a parkinson's plus syndrome or perhaps another illness has ocurred on top of the PD So I would take him to a movement disorder specialist as soon as possible. Contact the local office of the APDA, NPF or UPF for a referral. Diane ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn