title: Parkinson's disease with camptocormia.
abstract: BACKGROUND
  Camptocormia is defined as an abnormal flexion of the trunk that appears when standing or walking and disappears in the supine position. The origin of the disorder is unknown, but it is usually attributed either to a primary or a secondary paravertebral muscle myopathy or a motor neurone disorder. Camptocormia is also observed in a minority of patients with parkinsonism.
  
  
  OBJECTIVE
  To characterise the clinical and electrophysiological features of camptocormia and parkinsonian symptoms in patients with Parkinson's disease and camptocormia compared with patients with Parkinson's disease without camptocormia.
  
  
  METHODS
  Patients with parkinsonism and camptocormia (excluding patients with multiple system atrophy) prospectively underwent a multidisciplinary clinical (neurological, neuropsychological, psychological, rheumatological) and neurophysiological (electromyogram, ocular movement recording) examination and were compared with age-matched patients with Parkinson's disease without camptocormia.
  
  
  RESULTS
  The camptocormia developed after 8.5 (SD 5.3) years of parkinsonism, responded poorly to levodopa treatment (20%) and displayed features consistent with axial dystonia. Patients with camptocormia were characterised by prominent levodopa-unresponsive axial symptoms (ie, axial rigidity, gait disorder and postural instability), along with a tendency for greater error in the antisaccade paradigm.
  
  
  CONCLUSIONS
  We suggest that (1) the salient features of parkinsonism observed in patients with camptocormia are likely to represent a specific form of Parkinson's disease and camptocormia is an axial dystonia and (2) both camptocormia and parkinsonism in these patients might result from additional, non-dopaminergic neuronal dysfunction in the basal ganglia.
authors.affiliation: Centre d'Investigation Clinique-Fédération des Maladies du Système Nerveux, Groupe-Hospitalier Pitié-Salpêtrière, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Bloch
authors.forename: J L
authors.initials: JL
authors.lastname: Houeto
authors.forename: S
authors.initials: S
authors.lastname: Tezenas du Montcel
authors.forename: F
authors.initials: F
authors.lastname: Bonneville
authors.forename: F
authors.initials: F
authors.lastname: Etchepare
authors.forename: M L
authors.initials: ML
authors.lastname: Welter
authors.forename: S
authors.initials: S
authors.lastname: Rivaud-Pechoux
authors.forename: V
authors.initials: V
authors.lastname: Hahn-Barma
authors.forename: T
authors.initials: T
authors.lastname: Maisonobe
authors.forename: C
authors.initials: C
authors.lastname: Behar
authors.forename: J Y
authors.initials: JY
authors.lastname: Lazennec
authors.forename: E
authors.initials: E
authors.lastname: Kurys
authors.forename: I
authors.initials: I
authors.lastname: Arnulf
authors.forename: A M
authors.initials: AM
authors.lastname: Bonnet
authors.forename: Y
authors.initials: Y
authors.lastname: Agid
mesh_terms: D000368:Aged; D001479:Basal Ganglia / Q000503:physiopathology; D004421:Dystonia / Q000209:etiology* / Q000503:physiopathology; D004576:Electromyography; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D010300:Parkinson Disease / Q000150:complications* / Q000503:physiopathology*; D011187:Posture; D011446:Prospective Studies; D016138:Walking