Pramipexole-induced antecollis in Parkinson's disease.
We report a case of antecollis, or dropped head with Parkinson's disease (PD) induced by pramipexole, a nonergot dopamine agonist. An 80-year-old woman presented with progressively severe neck flexion, which developed within a few weeks of taking pramipexole at 3 mg/day. She had a disturbed gait and complained of difficulty in daily activity because of restricted visual field and severe stooped posture. Surface EMG showed disproportionate tonus of the neck muscles but needle EMG of the neck muscles was normal. Withdrawal of pramipexole resulted in immediate improvement; the patient could keep the head in natural position and walk normally. Pramipexole-induced antecollis may be serious, but is a reversible dystonia in patients with PD. Clinicians should be aware of such complication.
Suzuki
Masahiko
M
Department of Neurology, The Jikei University School of Medicine, 3 25 8, Nishi-Shinbashi, Minato-ku, Tokyo, 105 8461, Japan. suzukimd@jikei.ac.jp
Hirai
Toshiaki
T
Ito
Yasuhiko
Y
Sakamoto
Tsuyoshi
T
Oka
Hisayoshi
H
Kurita
Akira
A
Inoue
Kiyoharu
K
D000369:Aged, 80 and over; D052160:Benzothiazoles / Q000009:adverse effects*; D004298:Dopamine / Q000378:metabolism; D018491:Dopamine Agonists / Q000009:adverse effects*; D004409:Dyskinesia, Drug-Induced / Q000503:physiopathology*; D020821:Dystonic Disorders / Q000139:chemically induced* / Q000503:physiopathology*; D004576:Electromyography; D005260:Female; D019416:Head Movements / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007564:Japan; D009129:Muscle Tonus / Q000187:drug effects / Q000502:physiology; D009334:Neck Muscles / Q000187:drug effects / Q000503:physiopathology; D010300:Parkinson Disease / Q000188:drug therapy*; D011187:Posture / Q000502:physiology; D000077487:Pramipexole