ABSTRACT
CASE PRESENTATION In 1985, at age 34, a man with a history of alcohol abuse began to experience tremor and loss of dexterity in his right hand and dragging of the right foot. He came to medical attention at age 37 and was diagnosed as having Parkinson’s disease (PD). He was placed on levodopa/carbidopa, which produced a dramatic reduction in his symptoms and signs. Bromocriptine and selegiline were soon added. Within the first year of treatment he developed intermittent mild dystonic posturing or choreiform dyskinesias of the right arm and foot. Over the following year his dose of levodopa was incrementally increased from 400 to 900 mg per day, but often by the patient without consulting his physician. He also began to deviate from the prescribed dosing schedule, preferring to take the medication whenever he felt it was needed.
