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Upon reassessment after 3 months, all patients remained bed or wheel chair bound (HY 5) and presented significant worsening of their UPDRS part III score of at least 10 points (mean 51.5 ± 3.3; paired -test two-tailed 0.0001 compared to baseline). The mean dose of levodopa at baseline was 907.7 ± 149.8 mg (600-120 and significantly higher (paired -test two-tailed 0.0001) on follow-up, 1061.5 ± 175.8 mg (700-130. Clinical and surgical emergencies are major determinants for a progression of PD to more advanced stages. Cl