ABSTRACT
CASE PRESENTATION The patient is a 63-year-old woman who carries a diagnosis of idiopathic Parkinson’s disease (PD). She recalls the onset of her illness to be at least 5 years ago when she insidiously developed a resting tremor of the left hand. Subsequently, she noticed her movements were slower and her muscles felt stiff. She also complained of difficulty turning in bed and a softer voice. Her husband recalled that her facial expression decreased and her handwriting became smaller. On examination at that time, cognitive testing was normal. She was found to have a resting tremor of the left hand, bradykinesia, mild rigidity of the left limbs, reduced arm swing, and hypomimia. She was started on carbidopa/ levodopa with moderate improvement of her symptoms. For the 2 years prior to presentation, she had been on a stable dose of carbidopa/levodopa 25/100, oneand-a-half tablets, three times daily.
