Ropinirole-Induced Anterocollis in Parkinson's Disease

Abstract

Anterocollis or antecollis, also called dropped head, is characterized by disproportionate flexion of the head over the trunk and can result from either muscle weakness (i.e., myasthenia gravis and motor neuron disease) or muscle hyperactivity in cases of dystonia.[1]Anterocollis has been described in patients with Parkinson's disease (PD) or multiple system atrophy; however, it is still debated whether, in these cases, it is dystonic in nature or myopathic or both[2, 3] Anterocollis has also been described with use of antiparkinsonian medications, such as amantadine and certain dopamine agonists (DAs; cabergoline, pramipexole, or rotigotine).[2-7] We report here videotape evidence of anterocollis development secondary to ropinirole use, with full recovery after drug discontinuation.