A LONG-TERM FOLLOW-UP-STUDY OF CINNARIZINE-INDUCED AND FLUNARIZINE-INDUCED PARKINSONISM

The natural course of calcium-entry blocker-induced parkinsonism was e valuated in 13 elderly patients previously exposed to cinnarizine or f lunarizine or both for a median period of 7 months. Clinical assessmen ts were carried out before drug discontinuation and twice thereafter o ver a period lasting less than or equal to 7 years. None of the patien ts showed a full recovery of extrapyramidal signs, indicating that the long-term prognosis of the parkinsonism is less benign than previousl y reported. Two main patterns of clinical outcome were recognized (i.e ., ''remittent'' and ''persistent and not progressive'' parkinsonism), whereas the development of a progressive disorder was observed only i n one patient. No significant correlation was found between the patter ns of outcome and some clinical variables, such as total duration of e xposure to cinnarizine and flunarizine, cumulative drug dosages, and a ge at onset of parkinsonism. There was no significant difference in te rms of family history of essential tremor or parkinsonism or both amon g the patients with the two main patterns of clinical course.