In a double-blind trial with a placebo phase, low-dose bromocriptine therapy (average dose, 15 mg per day) produced a significant improvement in 25 idiopathic parkinsonian patients. Tremor and bradykinesia were equally and significantly improved in both the levodopa-treated and the de novo patients. Rigidity was most improved in the levodopa-treated subjects. Age was not a factor in determining the dose of bromocriptine or the degree of improvement. Adverse effects occurred in 30% but were mild and dose-dependent. Four subjects, unable to tolerate initial doses of bromocriptine, withdrew from the trial. A low initial dose (1 mg per day) and slow escalation in dosage produced an optimal, though delayed improvement. Low-dose bromocriptine therapy is effective, does not induce significant dyskinesia nor on-off phenomenon, and is probably an alternative to levodopa as a drug of first choice in Parkinson disease.

Homolateral ataxia and crural paresis is a recognized vascular syndrome. However, confirmation of the causative lesion rests principally on one earlier case with multiple other infarcts. We studied a patient with the clinical syndrome; computerized tomography revealed a lucency that appeared within 1 week of the infarct. Localization of the lesion to the superior portion of the posterior limb of the internal capsule and thalamus is in accord with the original conclusions of Fisher and Cole.

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