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Joe, you wrote I was puzzled to see in the authoritative Merck article >an allusion to *movement* in dystonia, and more so when Ida Kampuis >of this forum found a similar remark by an eminent specialist. But >careful reading will reassure you that movement is *not* a major >feature of dystonia. No doubt some quibblers may object, but I think >it's more productive to keep "dystonia" distinct from "dyskinesia". >Dystonia has other causes than only PD, but in PD dyskinesia, the >difference will help people understand what you're talking about Joe, I agree with you about keeping dystonia distinct from dyskinesia. Dystonia is about stiff or very stiff (cramping)muscles and dyskinesia about muscles that can't be stopped to cause movement. As a matter of fact I was amazed that I found the citation mentioned in "Movement Disorders". But I was also distracted from the subject by the things they wrote about the relation between their concept of dystonia and sinemet, which I have never read before. But to avoid confusion I will not talk about that now. My idea about dystonia is that there are two kinds of them. One in which the antagonistic muscles (the flexor and the extensor) are both stiffening and the other in which only one of them is (as in the notorious morning foot cramps) involved in the first place. This last one can be more painfull because by the postural abnormalities they cause some other tissue to overstretch. The contraction of the muscle that is not limited by an also contracting antagonist, can be more extreme. This kind of dystonia might be more or less centrally initiated. The other kind of dystonia can only be centrally initiated and causes generalized stiffness, loss off possibility of fine tuning of movements and fatigue. It is indicative of central neurologic disease. The confusing thing now is these both kinds of dystonia don't exclude each other nor do they exclude dyskinesia and so these manifestations cannot be seen in their pure form in every pwp and maybe they don't even exist in pure form. So another way to talk about this states is not to disentangle them, but see what are the real complexes of manifestations as they exist in relation to medicines and stages of the disease. That was the aim of the writers of the section from movement disorders, which I referred to in my first mail. Ida Kind regards / Vriendelijke groeten Ida Kamphuis