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Philip Donley wrote: Phil, A couple of things come to mind. First, the type of hallucinations that he is having coupled with periods of confusion are most likely, in my experience as a psychiatrist, medication related. Any of the meds he is taking for PD or the combination can be the cause. Is his neurologist a movement disorders specialist? He or you should talk with him/her about the hallucinations. a judicious med reduction or change might help. Otherwise Clozaril or another of the newer neuroleptics can be tried. I definitely feel everything possible within reason should be tried with medications before considering surgery in a 74 year old man. The key is to be sure he is seeing a good movement disorders specialist. PD treatment is so complex at this point and is changing so rapidly that it is almost impossible for the general neurologist to be "state of the art" with complicated PD. Charlie > Charlie, > > You asked me the other day to provide some more details about my > father's PD. > > He is almost 74 and has probably had PD for about 12 years, although > he has > only been receiving treatment for about 7 years. His primary problems > include > drooling, especially at night, nonstop nasal drainage, balance when > walking > (he takes some hard falls occasionally), and shortness of breath > (which used > to occur mostly in the evening but now occurs mostly in the morning > and > anytime he has to exert himself. He has recently started having cramps > and > muscle spasms. He experiences periodic confusion. He has recently had > the > sensation that people, usually one of my brothers or me, are in the > room with > him or standing next to him. He is experiencing fairly severe weakness > in his > voice; this occurs both when he is speaking and trying to sing in > church. He > does not have tremors in his hands, although when he stands still I > have > noticed that he seems to sway, almost as if he were being tossed about > in a > breeze. > > His non-PD conditions include macular degeneration, cataracts, double > vision > due to a muscular weakness, and glaucoma. > > His medications include Sinemet once every three hours (Carbidopa 200, > Levodopa 25/250), Permax 0.25 mg twice a day, and Eldepryl 5 mg. > capsules > twice a day. He takes various other vitamin and mineral supplements, > including Calcium, Vitamin E, Vitamin B, and Chromium Picolinate. > > I am very interested in anything that would improve this kind and > proud man's > way of life, whether it be drugs, surgery, or some kind of implant. > Any > information or insights that you or other members might have will be > very > much appreciated. > > Sincerely, > > Phil > (Philip Donley, Ph.D., Au stin, Texas, > [log in to unmask]) -- CHARLES T. MEYER, M.D. Middleton, WI [log in to unmask]