ABSTRACT
Dystonic features are not uncommon in patients with parkinsonian disorders, both primary and secondary (e.g., parkinsonism in which a specifi c cause is known, such as MPTP or manganese intoxication). In Parkinson disease (PD) prominent dystonia is uncommon before treatment is initiated except for some young-onset cases. Dystonia, on the other hand, is not uncommon in the early, unmedicated stages of patients with atypical parinsonisms such as progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), or multiple system atrophy (MSA), although these symptoms are infrequent as an early manifestation (Table 18.1).
