Dyskinesia in multiple system atrophy and progressive supranuclear palsy

In the differential diagnosis of Parkinson syndromes, the response to l-Dopa is an essential criterion for the diagnosis of idiopathic Parkinson’s syndrome (IPS), and the presence of l-Dopa-induced dyskinesia (LID) is considered a supportive criterion. This implies that in the presence of LID an atypical Parkinson-syndrome (APS) is unlikely. However, dyskinesia, and in particular LID, can also be present in APS such as MSA and PSP, although less frequently, and with varying clinical appearance. We conclude that whilst presence of dyskinesia provides support for a diagnosis of IPD, they do not allow reliable differentiation from APS.