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Drug-induced asterixis in Parkinson disease

Department of Neurological Sciences, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL.

Asterixis was observed in five parkinsonian patients who were taking levodopa. A prospective study revealed that 4 of 55 consecutive patients had asterixis. Liver and metabolic functions were normal in all patients. Asterixis always occurred as part of a toxic confusional state superimposed on a parkinsonian state associated with some dementia. Insomnia, hallucinosis, and myoclonus were also prominent in the affected patients. Because of this association with other signs of chronic drug toxicity and its reversal with drug withdrawal, the asterixis seemed to be drug-related.

Address correspondence and reprint requests to Dr. Glantz, Department of Neurological Sciences, Rush-Presbyterian-St. Luke's Medical Center, 1725 W. Harrison, Chicago, IL 60612.

Presented in part at the thirty-third annual meeting of the American Academy of Neurology, Toronto, Canada, April 1981.

Supported by grants from the United Parkinson Foundation and the Boothroyd Foundation, Chicago, IL. Dr. Goetz is the recipient of an NINCDS Teacher-Investigator Award.

Accepted for publication October 12, 1981.