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Dystonia in parkinson's disease: Clinical and pharmacological features
Author(s) -
Poewe W. H.,
Lees A. J.,
Stern G. M.
Publication year - 1988
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410230112
Subject(s) - dystonia , parkinsonism , neurochemical , basal ganglia , levodopa , pathophysiology , medicine , parkinson's disease , dyskinesia , movement disorders , disease , deep brain stimulation , pallidotomy , neurological disorder , neuroscience , psychology , central nervous system disease , anesthesia , central nervous system
We studied the features of dystonia in 9 patients with untreated idiopathic Parkinson's disease and in 56 patients on sustained treatment with L‐dopa. Dystonia was seen as an initial symptom in patients with both early‐ and late‐onset Parkinson's disease and included action dystonia of the limbs and cranial dystonia. Although the coexistence of parkinsonism and dystonia suggests a common pathophysiology, antiparkinsonian drugs did not consistently influence dystonic spasms. L‐dopa‐induced dystonia was seen as an off‐period, biphasic, or peak‐dose phenomenon. Each type showed a distinctive pattern of localization of dystonic spasms, possibly reflecting neurochemical aspects of basal ganglia somatotopy. Neuropharmacological studies performed in 12 patients suggest that off‐period dystonia is genuinely induced by L‐dopa and best relieved by antiparkinsonian agents.