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Although dyskinesia is well recognized in Parkinson's disease, it is generally under acknowledged in multiple system atrophy (MSA). Reported cases of dyskinesia primarily manifest in patients with MSA with predominant parkinsonism (MSA-P), and characteristically present as orofacial dystonia. However, we have observed other manifestations of dyskinesia in our clinical practice. The current report aims to present the specific manifestations of dyskinesia in MSA-P, with videos.
We enrolled six patients with MSA-P with dyskinesia from Xuanwu Hospital. Of these, four had clinically established MSA-P and two had clinically probable MSA-P according to the 2022 Movement Disorder Society criteria for MSA diagnosis. All six patients underwent an acute levodopa challenge test, and videos were recorded during the process.
Dyskinesia had a unilateral distribution in four patients. Three patients presented with peak-dose orofacial dystonia; of these, two were associated with blepharospasm and two were associated with limb dystonia. In addition, we observed that one patient had peak-dose distal lower limb dystonia with upper limb chorea, one patient had wearing-off dystonia of the eyelids, and one patient had diphasic generalized chorea mimicking that of Parkinson's disease.
In addition to orofacial dystonia, the topographic patterns of dyskinesia in MSA-P can manifest as limb dystonia, blepharospasm, and generalized chorea. Moreover, the temporal patterns of dyskinesia in MSA-P can be peak-dose, wearing-off, or diphasic.
Espay AJ, Morgante F, Merola A, et al. Levodopa-induced dyskinesia in Parkinson disease: current and evolving concepts. Ann Neurol. 2018;84(6):797–811. https://doi.org/10.1002/ana.25364.
Jost WH, Lingor P, Tonges L, et al. Dyskinesia in multiple system atrophy and progressive supranuclear palsy. J Neural Transm. 2019;126(7):925–932. https://doi.org/10.1007/s702-019-02012-0.
Postuma RB, Berg D, Stern M, et al. MDS clinical diagnostic criteria for Parkinson's disease. Mov Disord. 2015;30(12):1591–1601. https://doi.org/10.1002/mds.26424.
Wenning GK, Tison F, Ben Shlomo Y, et al. Multiple system atrophy: a review of 203 pathologically proven cases. Mov Disord. 1997;12(2):133–147. https://doi.org/10.1002/mds.870120203.
Wenning GK, Stankovic I, Vignatelli L, et al. The Movement Disorder Society Criteria for the Diagnosis of Multiple System Atrophy. Mov Disord. 2022;37(6):1131–1148. https://doi.org/10.1002/mds.29005.
Tomlinson CL, Stowe R, Patel S, et al. Systematic review of levodopa dose equivalency reporting in Parkinson’s disease. Mov Disord. 2010;25(15):2649–2653. https://doi.org/10.1002/mds.23429.
Boesch SM, Wenning GK, Ransmayr G, et al. Dystonia in multiple system atrophy. J Neurol Neurosurg Psychiatry. 2002;72(3):300–303. https://doi.org/10.1136/jnnp.72.3.300.
Thongchuam Y, Panyakaew P, Bhidayasiri R. Orofacial dystonia and asssociated bulbar symptoms in multiple system atrophy: A blinded video analysis. J Neurol Sci. 2020;417:116992. https://doi.org/10.1016/j.jns.2020.116992.
Hughes AJ, Colosimo C, Kleedorfer B, et al. The dopaminergic response in multiple system atrophy. J Neurol Neurosurg Psychiatry. 1992;55(11):1009–1013. https://doi.org/10.1136/jnnp.55.11.1009.
Marsili L, Bologna M, Kojovic M, et al. Dystonia in atypical parkinsonian disorders. Parkinsonism Relat Disord. 2019;66:25–33. https://doi.org/10.1016/j.parkreldis.2019.07.030.
Yoon WT. Comparison of dystonia between Parkinson's disease and atypical parkinsonism: The clinical usefulness of dystonia distribution and characteristics in the differential diagnosis of parkinsonism. Neurol Neurochir Pol. 2018;52(1):48–53. https://doi.org/10.1016/j.pjnns.2017.11.004.
Petzinger GM, Fisher BE, McEwen S, et al. Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson's disease. Lancet Neurol. 2013;12(7):716–726. https://doi.org/10.1016/S1474-4422(13)70123-6.
Reis J, Fritsch B. Modulation of motor performance and motor learning by transcranial direct current stimulation. Curr Opin Neurol. 2011;24(6):590–596. https://doi.org/10.1097/WCO.0b13e32834c3db.
Huang H, Sharma HS, Chen L, et al. Neurorestoratology: New Advances in Clinical Therapy. CNS Neurol Disord Drug Targets. 2023;22(7):1031–1038. https://doi.org/10.2174/1871527321666220827093805.
Huang H, Chen L, Chopp M, et al. The 2020 Yearbook of Neurorestoratology. J Neurorestoratology. 2021;9(1):1–12. https://doi.org/10.26599/JNR.2021.9040002.
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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