Physostigmine in choreiform movement disorders

Abstract

Dopaminergic-cholinergic balance is a clinically observable phenomenon in Parkinson9s disease and in L-dopa-induced dyskinesia. In a series of 30 patients with a variety of choreiform movement disorders, including Huntington9s disease, L-dopa-induced dyskinesia, and tardive dyskinesia, we have been unable to dernonstrate consistent cholinergic responsiveness. Intravenous physostigmine reduced chorea in Huntington9s disease in only two of 12 patients, whereas choreiform movements were abolished or suppressed in five of seven patients with L-dopa-induced dyskinesias.