A 68-year-old male was diagnosed wi

A 68-year-old male was diagnosed with Parkinson's disease 8 years previously. Initial symptoms were intermittent tremor of his right hand when sitting or lying plus a subjective feeling of incoordination of his right leg wher walking. He was initially put on ropinirole 12mg daily, resulting in marked and sustained relief from his symptoms. He functioned more or less normally for approximately one year after which time he began to experience re-emergence of tremor and gait difficulties with some general slowness and ropínirole was increased to 20mg daily. The patient again enjoyed good benefit.After some further 12 months he began to notice re-emergence of symptoms so levodopa 100mgx4 daily was added. His motor fluctuations partlally resolved for 3 months then re-emerged.