I haven't seen this in 'official' literature, but IMHO this kind of dystonia
may be due to effect of PD on the peripheral, rather than the central,
nervous system. Maybe the carbidopa component of regular Sinemet is too
effective in preventing delivery of dopamine to anywhere outside the brain.
Any comment, experts?
Cheers, Joe
J. R. Bruman (818) 789-3694
3527 Cody Road
Sherman Oaks CA 91403
On Sat, 4 May 1996, Kenneth Goodrich wrote:
> Perhaps I should be replying only to those persons who asked about
> "curling toes," but since many more people may be interested, I will risk
> replying to the entire list.
>
> I believe this problem is really a dystonia, one of the sub-afflictions of
> PD. I have read that it can occur as a result of levodopa excess ("peak
> dose dystonia) OR when levodopa is at a low level ("off period dystonia),
> such as during an "off" period or just before a new dose is needed. For
> the former, treatment may consist in reducing each dose of Sinemet, with
> or without adding a dopamine agonist to compensate for the lesser amount
> of Sinemet. For the latter, various changes in medications (e.g.,
> Sinemet-CR) may be needed to smooth out the therapeutic response to
> Sinemet.
>
> It is not clear to me that hammer toes result from this toe-curling
> dystonia, but I could be wrong. The person who referred to thickened toe
> nails in the context of hammer toes was probably talking about toe nail
> fungus, not hammer toes.
>
> Hope this helps.
>
> * * * * * * * * * * * * * * * * * * * * * * * * * *
> Ken Goodrich, Caregiver
> Columbus, Ohio
>
