Dystonia in Parkinson's disease: clinical and pharmacological features.
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.
Poewe
W H
WH
University Clinic for Neurology, Innsbruck, Austria.
Lees
A J
AJ
Stern
G M
GM
D000328:Adult; D000368:Aged; D002940:Circadian Rhythm; D004305:Dose-Response Relationship, Drug; D004421:Dystonia / Q000139:chemically induced / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007275:Injections, Intravenous; D007980:Levodopa / Q000009:adverse effects; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology
D007980:Levodopa