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August 1982

Parkinson's Disease With Diphasic Dyskinesia and Early-Morning Dystonia

Author Affiliations

Division of Neurology Department of Medicine Showa University Fujigaoka Hospital 1-30 Fujigaoka, Midori-ku, Yokohama 227, Japan
National Center for Nervous, Mental and Muscular Disorders Kodaira, Tokyo, 187, Japan

Arch Neurol. 1982;39(8):531. doi:10.1001/archneur.1982.00510200073020

To the Editor.—  Diphasic dyskinesia1-3 and early-morning dystonia4 in parkinsonian patients have been reported separately. Here we describe a parkinsonian patient with both early-morning dystonia and diphasic dyskinesia.

Report of a Case. —  A 44-year-old woman, in the spring of 1979, began to have a tremor of her left hand and began to feel stiffness of her left arm in the autumn and winter of the same year in activities such as dressing. Tremor of the hand was intensified with the stiffness, so that buttoning a coat became difficult. Her left leg also became involved, which rendered it difficult to put on or take off slippers and shoes. She came to the Neurology Clinic of Showa University Fujigaoka Hospital on May 16, 1980.On examination, she had slightly oily and masked facies and decreased blinking. Muscle stretch reflexes of the limbs were slightly diminished. Cogwheel rigidity was observed