A woman in her sixties was admitted to the hospital after she had a generalized epileptic seizure. For the last 20 years, she had Parkinson disease. Her clinical history additionally included coronary heart disease, type 2 diabetes, and obesity. Her Parkinsonian symptoms included postural instability, bladder dysfunction, rigidity, tremor, and dystonia in the neck and lower extremities. She had used Sinemet (carbidopa/levodopa) 25/100 mg 10 times daily for at least 10 years, in addition to tolcapone 100 mg 3 times daily and botulinum toxin for dystonia. During the previous 3 months before admittance to hospital, she had experienced increasing nausea, vomiting, dizziness and stomach pain, and reduced walking ability. In this period, she also had several serious infections and a weight loss of approximately 30 kg.