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Dominick J. H. McCabe, PhD, FRCPI; Elijah C. Chaila, MRCPI; Norman Delanty, FRCPI; Danny Costello, MRCPI; Raymond P. Murphy, FRCP

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In reply

We thank Dr Horstink and colleagues for their interest in our article¹ and for their informative comments regarding the neurophysiological basis of the extensor plantar response in patients with pyramidal tract dysfunction and the putative neurophysiological mechanisms responsible for the "pseudo-Babinski" response in patients with dystonia. The focus of our manuscript was to broaden the phenotype of DRD and to highlight the fact that patients with genetically confirmed DRD may have "cerebellar signs" that may also improve in response to levodopa therapy. Nevertheless, some points raised by Horstink et al deserve discussion.

There have been several reports of patients with DRD presenting with clinical features suggestive of spasticity,^2-4 resulting in the initial misdiagnosis of hereditary spastic paraparesis or cerebral palsy^5-6 and a subsequent inadvertent delay in the commencement . . . [Full Text of this Article]

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RELATED LETTER

Babinski, Pseudo-Babinski, and Dystonia
Martin W. I. M. Horstink, Charlotte Haaxma, Bastiaan R. Bloem, and Jaak Duysens
Arch Neurol. 2007;64(8):1207-1209.
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Broadening the Phenotype of Childhood-Onset Dopa-Responsive Dystonia
Elijah C. Chaila, Dominick J. H. McCabe, Norman Delanty, Danny J. Costello, and Raymond P. Murphy
Arch Neurol. 2006;63(8):1185-1188.
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