### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My mother has 71 years now and has developed Parkinsons before 4 years. Started with an involantary lip/mouth movement without any movement disorder and started taking 4 syndopa. Now she is taking 4 syndopa+ and 1.5 Pacitane daily. But most of time she is inactive and cant able to walk and many times she sits closing her eyes and sometimes she has no proper memory. Many times she urinates in chair and agitates to take food. She cant properly open her mouth and not even hear(or not pay attentiion) and respond to our requests. Sir, I am totally confused and I suspect that this may be a mis diagnosis of Parkinsons because of memory problem and not (sometimes) responding to Syndopa. I request you an expert advice regarding this

### output:

Hello... welcome to Chat Doctor ... as after reviewing your mothers case, there is need to perform MRI BRAIN to rule out any history of cerebrovascular stroke- ischemia / infarction to brain. 2nd differential diagnosis, it may be dementia - cerebral cortical atrophic changes that can also be seemed in MRI BRAIN. First, I would like to know if your mother has comorbid hypertension or diabetes, as in presence of this, possibility of 2 differential diagnosis increases much. If there is presence of infarction than need to add anticoagulant like aspirin, clopidogrel & cognitive enhancers like paracetamol / citicholine. If there is advance dementia than need to add rivastigmine / donepezil to preserve acetyl choline reserve for memory. Kindly do brain imaging & follow afterwards advice. I am sure it would be helpful to get better from current clinical condition. See you. Bye...