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How to manage Parkinsonism?

Q: My Father is 70 years old and is suffering from Parkinsonism for the last 5 years. The disease was almost controlled with the drug SYNDOPA-110 TDS. Recently he developed pneumonia and was hospitalised (Tirath Ram Shah, New Delhi) and during this phase his Parkinsonism got aggravated. At the moment his medication includes: 1. SYNDOPA 110 TDS 2. ROPARK - 2 Mg TDS (0.75 Morning-0.75Afternoon-0.50 Evening. Ropark was added around 20 days back) At the moment he is bed ridden and both his upper and lower limbs are very stiff. He cannot swallow and hence is on Ryles tube feeding. His face looks expressionless and he doesnot speak anything. We are back home and have hired private nursing care. We keep moving his joints with some light physiotherapy ( every 4 hours) which we learnt from the physio-therapist in the hospital. Kindly advise if there is a better medication or a cure or do I need to take a second opinion of some super specialist Neurologist in Delhi? In that case please let me know the name/names of the Doctors in Delhi.

A:Apparently there is deterioration in parkinsonian features due to recent pneumonia and needs readjustment of medication. The dose of Syndopa should be gradually increased to a level which is just enough to control the symptoms without producing significant side effects. Besides, other medicines which are helpful in Parkinsons disease may be coprescribed (Ropark is one of them). It needs to be done under the supervision of a neurologist and it is suggested that you consult one for appropriate management.

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