DOPE-RESPONSIVE CHILDHOOD DYSTONIA - A FORME-FRUSTE WITH WRITERS CRAMP, TRIGGERED BY EXERCISE

An 11-year-old girl was evaluated for walking difficulties and fatigue at the end of the day in the last 2 years, Handwriting was also diffi cult with 'cramps' after a short time of writing, Neurological examina tion was normal most of the time but in the evening and after exercise , an abnormal walking posture and rare dystonic movements of the foot could sometimes be seen, The mother was found to have mild parkinsonis m and is asymptomatic on L-dopa, In the daughter, all symptoms and sig ns disappeared on L-dopa, but returned when the drug was withdrawn, Th e changes on- and off-treatment were documented with videofilms and co mputerized analysis of writing samples, The situation has been stable during a 5-year follow-up. We draw attention to this 'forme fruste' of dopa-sensitive childhood dystonia which becomes manifest with exercis e and which can easily go unrecognized. We also discuss and illustrate the methods used for the analysis of writing.