Reversible antecollis associated with pramipexole in a patient with Parkinson's disease

J Clin Neurosci. 2012 Jun;19(6):903-4. doi: 10.1016/j.jocn.2011.09.015. Epub 2012 Feb 20.


Antecollis is a frequent complication in multiple system atrophy but is rare in Parkinson's disease (PD). We report an 80-year-old patient with a four-year history of PD who developed antecollis six weeks after taking pramipexole (1 mg/day). When assessed in the outpatient clinic, she had antecollis, cogwheel rigidity on the right side, and mild bradykinesia. We found no evidence of myopathic or neurogenic changes in the neck muscles on needle electromyography. We withdrew the pramipexole immediately, and, one week later, her antecollis improved dramatically. This report emphasizes the importance of considering dopamine agonists as a possible cause of antecollis and shows that immediate withdrawal of these drugs may reverse the symptoms.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antiparkinson Agents / adverse effects*
  • Benzothiazoles / adverse effects*
  • Dyskinesia, Drug-Induced / etiology*
  • Electromyography
  • Female
  • Humans
  • Muscle Rigidity / chemically induced
  • Neck Muscles / drug effects
  • Neck Muscles / physiopathology
  • Parkinson Disease / drug therapy
  • Pramipexole


  • Antiparkinson Agents
  • Benzothiazoles
  • Pramipexole