1.Cervical dystonia in Parkinson’s disease: Retrospective study of later-stage clinical features
Hiroshi Kida ; Shiroh Miura ; Yoshihiro Yamanishi ; Tomoyuki Takahashi ; Takashi Kamada ; Akiko Yorita ; Mitsuyoshi Ayabe ; Hideki Kida ; Tomoaki Hoshino ; Takayuki Taniwaki
Neurology Asia 2018;23(3):245-251
Objective: Cervical dystonia (CD) is a clinically under-recognized symptom occurring at the later- to
end-stages of Parkinson’s disease (PD). The frequency of CD and its influence on prognosis have
not been well studied. Here, we conducted an in-depth examination of CD incidence and impact on
disease progression in later-stage PD. Methods: We retrospectively reviewed the clinical features of 22
deceased patients with sporadic PD treated at a hospital in Japan from 1983 to 2008. Results: The most
common cause of death in PD was pneumonia. CD, in particular retrocollis, was frequent in the later
stages of the disease in elderly patients (9/22, 40.9%). Pneumonia incidence increased sharply in the
later period with CD. There was a positive trend between CD duration and duration of pergolide use.
Conclusion: Analysis revealed that CD increases markedly in late- to end-stage PD, which may be
associated with aspiration pneumonia due to dysphagia. Pathological mechanisms underlying CD might
be influenced by treatments including dopamine agonists. Prevention of CD may increase quality of
life and prolong survival of PD patients.
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