Parkinson's follow-up letter

Diagnosis: 1. Parkinson's Disease, diagnosed 2018 2. Hypertension 3. Osteoarthritis Current Medications: 1. Levodopa/Carbidopa 100/25mg, three times daily 2. Amlodipine 5mg, once daily Management Plan: 1. Continue current medication regimen. 2. Review medication side effects at next visit. 3. Encourage regular exercise and physical therapy. I followed up with this patient in the neurology clinic. He tells me that he has experienced a slight increase in tremor in his right hand over the past month. He reports that his motor function has been relatively stable, but he has noticed some mild stiffness in the mornings. He denies any new falls or episodes of freezing of gait. He reports that his medication is wearing off towards the end of the day. Motor function is generally stable, with mild tremor in the right hand. Mobility is good, with no reported falls in the last month. There is no freezing of gait. The patient reports wearing off of dopaminergic medications towards the end of the day. There is no levodopa induced dyskinesia. Mood is stable, with no symptoms of depression or anxiety. Memory is intact. There are no visual hallucinations. Sleep is disturbed, with difficulty falling asleep. He denies urinary frequency, urgency, or incontinence. Constipation is present. No postural lightheadedness. He denies any impulse control behaviours. His wife reports that the patient's symptoms have been stable over the past month. The patient lives at home with his wife. He does not consume alcohol or tobacco. He denies any drug use. He is still driving. Results of previous investigations: MRI brain scan in 2018 showed mild age-related changes. The neurological examination: Mild resting tremor in the right hand. Bradykinesia noted. Rigidity is present in the right upper extremity. Gait is normal. Reflexes are 2+ and symmetrical. Cranial nerves II-XII are intact. Summary & Recommendations: The patient's Parkinson's Disease is relatively stable, with some mild worsening of tremor and wearing off of medication. Continue current medication regimen. Review medication side effects at the next visit. Encourage regular exercise and physical therapy. Schedule a follow-up appointment in three months.