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You wrote: > >Hi, > My name is Jim Griesser. My father, Bob, who is 69 yrs. old, lives in >Cleveland, >Ohio and has had Parkinson's for about 20 years. Although the PD has progressed > >over the years he has been able to continue to live at home with my mother. > > On October 1st my father took nasty fall, cutting his head and really >banging up >his nose. My mother, an ex-RN, patched him up. Everything seemed fine, but >the next afternoon my father went into respiratory arrest. He is still in the >hospital. > > Apparently my father has become VERY sensitive to the Sinemet he's been >taking, >and when he takes it his jaw (and throat muscles to a lesser extent) "lock-up" >and >he's unable to open and breathe through his mouth. (So with a bruised and >swollen >nose he was unable to breathe at all...) > > In the hospital they took him off the Sinemet for a few days, but when they > >put him back on it he began to have severe, full body "seizures" (for lack of a >better >word). Now, I've seen his reactions to Sinemet before, even episodes where his > >entire torso twisted around, but never anything like this. It scared the >nurses. His >blood pressure dropped, pulse soared, and blood "oxygenation" level decreased >during >these episodes. > > Interestingly enough Benadryl (yes, that same stuff you can buy in the drug > >store) keeps his reaction to Sinemet pretty much under control. Just why this >is >nobody (Doctors included) seems to know. (I understand that years ago, before >L-dopa, Benadryl was used as a medication for PD patients.) The problem is that >the combination of the Sinemet and Benadryl has made him so tired, sleepy and >mentally confused that I'm not sure if he'll ever be able to return home. > > Now to my questions... > >1. Anyone ever have or hear of someone having this type of reaction to Sinemet? > (By the way he was taking Sinemet 250/25 4 times daily when this occurred). > >2. Anyone ever have problems with jaw/throat "locking up" when taking Sinemet? > >3. How about Benadryl? Does anyone take that with Sinemet? > >4. Anyone have recommendations for a *great* neurologist in the Cleveland area? > >5. They've also put my father on Permax. What has the experience of people been > with it? > > Wow, this is the longest letter I think I've ever written - sorry. > > - Regards, [log in to unmask] > > Jim: Insist on a CT scan immediately (if one has not been done recently)! Your father could have sustained an intracranial injury in his fall (a subdural hematoma or blood clot on the brain). These clots are usually curable with surgery and can do all of the things that you have reported (and with a delayed action). Tell me what happens! Anecdote (from my training days): "Uncle Charlie was 85 years old and sharp as a tack. Then, one day, Uncle Charlie fell down the stairs and broke his hip. He recovered from his hip fracture OK, but suddenly got old. He wound up in a nursing home and eventually died. At autopsy, a subdural hematoma was found, this coming from the same injury which caused the fractured hip". Get a neurosurgical consultation and a CT scan! Best wishes, Bob -- ******************************************************** Robert A. Fink, M. D., F.A.C.S. Phone: 510-849-2555 Neurological Surgery FAX: 510-849-2557 2500 Milvia Street Suite 222 Berkeley, California 94704-2636 USA E-Mail: [log in to unmask] CompuServe: 72303,3442 America Online: BobFink "Ex Tristitia Virtus" ********************************************************