Dystonia in Parkinson's disease: clinical and pharmacological features

Ann Neurol. 1988 Jan;23(1):73-8. doi: 10.1002/ana.410230112.


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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Circadian Rhythm
  • Dose-Response Relationship, Drug
  • Dystonia / chemically induced
  • Dystonia / drug therapy
  • Dystonia / etiology*
  • Dystonia / physiopathology
  • Humans
  • Injections, Intravenous
  • Levodopa / adverse effects
  • Middle Aged
  • Parkinson Disease / complications*
  • Parkinson Disease / drug therapy
  • Substance Withdrawal Syndrome / physiopathology


  • Levodopa