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Dystonia and other deformities in Parkinson's disease

  • Joseph Jankovic
    Correspondence
    Tel.: +1 713 798 5998; fax: +1 713 798 6808.
    Affiliations
    Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, 6550 Fannin, Suite 1801, Houston, TX 77030, United States
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      Distal limb deformities in patients with Parkinson's disease (PD) have been recognized over a century ago by Charcot and Purves-Stewart [
      • Ashour R.
      • Tintner R.
      • Jankovic J.
      “Striatal” hand and foot deformities in Parkinson's disease.
      ]. While some of the abnormal postures represent skeletal deformities, referred to as “striatal” hands and feet (Fig. 1, Fig. 2), dystonia may be another mechanism for the abnormal postures [
      • Jankovic J.
      • Tintner R.
      Dystonia and parkinsonism.
      ]. Although Singer and Papapetropoulos [
      • Singer C.
      • Papapetropoulos S.
      Lower limb post-immobilization dystonia in Parkinson's disease.
      ] state in their paper in this issue of the journal that “dystonic deformities of the hands and feet are rare,” this feature of PD is probably much more common than realized, and when present, it can markedly contribute to the overall disability and can adversely impact patient's quality of life.
      Figure thumbnail gr1
      Fig. 1Typical striatal hand deformity manifested by flexion of the metacarpophalengal and distal inter-phalangeal joints as well as extension of the proximal inter-phalangeal joints.
      Figure thumbnail gr2
      Fig. 2Striatal hand and foot deformities in a patient with PD.
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