Sleep tonus inversion: a feature of juvenile dystonic parkinsonism

A. Catz, L. Mendelson, J. J.M. Askenasy*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


ABSTRACT— Polysomnographic monitoring of a 16‐year‐old girl suffering from dopa‐responsive dystonic parkinsonism showed a change in the distribution of muscle activity in thigh muscles during different stages of sleep. The hamstring muscles were hypertonic at sleep onset compared with the vastus lateralis of the quadriceps muscles. At the third sleep cycle of each of the 2 nights, the time at which sleep benefit becomes clinically evident, the hypertonia in the hamstring muscles was reversed and the vastus lateralis became more hypertonic. It is suggested that the muscle tonus inversion marks the moment at which the sleep process alleviates the dystonic parkinsonian state manifested at wakefulness as a circardian fluctuation. According to our data, the flexor‐extensor tonus inversion during sleep was not yet described in the literature, and may be an associated feature of dopa‐responsive dystonic parkinsonism.

Original languageEnglish
Pages (from-to)472-475
Number of pages4
JournalActa Neurologica Scandinavica
Issue number5
StatePublished - Nov 1989
Externally publishedYes


  • dopa responsiveness
  • dystonia
  • sleep reversal dystonia
  • tonic activity inversion


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