Question: Hello Sir/Mam , My 64 year old Aunt recently got diagnosed by parkinsonism tremors AND rigidity on her right hand ,actually the right side of her body shows parkinsonism ,besides she is a diabetic as well .We consulted a couple of Docs in Bangalore ,took Brain MRI scan , and it seems like some ischemic changes on the left part of the Brain is causing parkinsonism on the right side , that is what the neurologist suggest .For the time being they have asked her to take strocit 500 /methylcobal 1000mcg and pyridoxal 5 phosphate 50 mg supplement daily for 3 months it is 2 months already she is with this medication except for p5p supplement , which i could not get anywhere on any drugstore , her condition so far remain the same , with mild to moderate tremors on right side e, but rigidity got relaxed a lill bit , and she is having a general weak syndrome , her right hand is getting weak , even though the rigidity is relaxed . Should i try getting p5p suypplement ,and start the thearpy , Doc does'nt want to start the Ldopa thearapy as of now , he want to monitor it for 6 months based on these supplements . Please guide me , if this is a parkinsonism , should'nt we start ldopa treatment immediately

Hello Doctor , Thanks so much for the reply ,i would like to know more on vascular parkinsonism ,is it reversible to some extent , or just like typical PD, there cannot be any cure for this as well ,also what are the advances we have made in these scenarios , all i know about parkinsons and parkinsonism is till date there is no cure formulated , but the anti parkinson drugs will XXXXXXX off over a period of time . Sir , also i would like to test her for B12 as my aunt is a strict Veg ,and does'nt even drink milk or have any beverages of milk .We started the methylcobal tablet two months back or till now there was not even a b12 supplement also, but lately it is also striking my mind . Please suggest a good B12 test available in Hyderabad ,apart from serum level test which may not be accurate all the times . I know B12 supplement tablets may not be effective if the deficiency is large . so what would be the best way to treat in case of a b12 deficiency I have read couple of docs on b12 deficiency ,which is synonimous to her current symptoms , except for tremors , she has general body weakness ,littile bit irritable ,and does'nt seem to be energetic ,however it can be a stroke/parkinsonism as welll .so just want to clear And what would be the best anti parkinson drug to begin with which will have min side effects and the dosage as well to begin with Thanks a lot for your time !

Hello Doctor , I was eagerly awaiting for your reply .Thanks for the detailed explanation ,.I will start with the medication of pramipexole; and 2 mg two-three times daily for trihexiphenidyl. Just want to know one last thing , should i continue Strocit , or shall i drop it , My Neurologist had asked me to continue this tablet one per day for 3 months , and she is taking this medicine for 20 odd days now . Thanks again for your help as usual ! Best Regards