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Martin W. I. M. Horstink, MD, PhD; Charlotte Haaxma, MD; Bastiaan R. Bloem, MD, PhD; Jaak Duysens, MD, PhD

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Chaila et al¹ described patients with dopa-responsive dystonia (DRD) and extensor plantar responses in 3 of 4 patients, brisk lower limb reflexes in all 4, and spasticity in 1 patient. The hyperreflexia decreased and the plantar responses became flexor within 6 to 12 months of treatment in the patients in whom these signs were initially present. The authors concluded that DRD may cause early-onset dystonia with extrapyramidal or pyramidal tract dysfunction. However, we want to discuss that both reflexive dorsal extension of the great toe and hyperreflexia of tendon reflexes may be caused by dystonia itself rather than by dysfunction of the pyramidal tract. Dystonic pseudo-Babinski and pyramidal Babinski may be caused by different neurophysiological mechanisms.

Dystonia is thought to result from sensorimotor disorder² that also manifests itself in dystonic syndromes . . . [Full Text of this Article]

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RELATED LETTER

Babinski, Pseudo-Babinski, and Dystonia—Reply
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Broadening the Phenotype of Childhood-Onset Dopa-Responsive Dystonia
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