{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:36:42Z","timestamp":1791333402509,"version":"4.3.1"},"reference-count":16,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:00:00Z","timestamp":1689292800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Amantadine is a widely prescribed medication in Parkinson's disease (PD). A distinctive craniofacial distribution of myoclonus with speech impairment is an underrecognized iatrogenic complication in amantadine\u2010treated patients with PD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Cases<\/jats:title><jats:p>We report 7 patients with idiopathic PD (disease duration, 6\u201321\u2009years) who developed speech\u2010induced craniofacial\u2010predominant myoclonus with \u201cstuttering\u2010like\u201d dysarthria and speech arrests days to months after amantadine initiation or dose increase. Renal insufficiency was identified as a risk factor in 4 cases. In all cases, reduction or discontinuation of amantadine markedly attenuated the myoclonus and restored speech intelligibility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Literature Review<\/jats:title><jats:p>Amantadine can induce subcortical segmental or generalized myoclonus. A report in 1996 of \u201cvocal myoclonus\u201d in an amantadine\u2010treated patient with PD was the first observation of a focal distribution of myoclonus, particularly affecting speech. Since then, few cases of craniofacial myoclonus with speech impairment have been reported, none with accompanying video. With 1 exception, the craniofacial distribution was part of a generalized pattern of amantadine\u2010induced myoclonus. Comorbid renal insufficiency is a recognized risk factor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Speech\u2010induced craniofacial myoclonus, with marked \u201cstuttering\u2010like\u201d dysarthria and speech arrests, is a disabling iatrogenic complication in PD that resolves upon amantadine discontinuation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.13828","type":"journal-article","created":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T08:07:10Z","timestamp":1687939630000},"page":"1408-1413","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Amantadine\u2010Induced Craniofacial Myoclonus: Distinctive Iatrogenic Dysarthria in Parkinson's Disease"],"prefix":"10.1002","volume":"10","author":[{"given":"Iris","family":"Lin","sequence":"first","affiliation":[{"name":"James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Armengou\u2010Garcia","sequence":"additional","affiliation":[{"name":"Edmond J. Safra Program in Parkinson's Disease, Rossy Progressive Supranuclear Palsy Centre and the Morton and Gloria Shulman Movement Disorders Clinic Toronto Western Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanskriti","family":"Sasikumar","sequence":"additional","affiliation":[{"name":"Edmond J. Safra Program in Parkinson's Disease, Rossy Progressive Supranuclear Palsy Centre and the Morton and Gloria Shulman Movement Disorders Clinic Toronto Western Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Kuhlman","sequence":"additional","affiliation":[{"name":"James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan H.","family":"Fox","sequence":"additional","affiliation":[{"name":"Edmond J. Safra Program in Parkinson's Disease, Rossy Progressive Supranuclear Palsy Centre and the Morton and Gloria Shulman Movement Disorders Clinic Toronto Western Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1229-3667","authenticated-orcid":false,"given":"Anthony E.","family":"Lang","sequence":"additional","affiliation":[{"name":"Edmond J. Safra Program in Parkinson's Disease, Rossy Progressive Supranuclear Palsy Centre and the Morton and Gloria Shulman Movement Disorders Clinic Toronto Western Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto J.","family":"Espay","sequence":"additional","affiliation":[{"name":"James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1212\/01.CON.0000436156.54532.1a","article-title":"Myoclonus","volume":"19","author":"Espay A","year":"2013","journal-title":"Continuum (N Y)"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2022.04.002"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870110123"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23140"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.56.2.279"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-016-8357-z"},{"issue":"1","key":"e_1_2_7_8_1","first-page":"6","article-title":"Amantadine","volume":"1300","year":"2010","journal-title":"React Wkly"},{"issue":"6","key":"e_1_2_7_9_1","first-page":"695","article-title":"Toxic effects of amantadine in patients with renal failure","volume":"120","author":"Ing T","year":"1979","journal-title":"Can Med Assoc J"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-94-4-454"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000095147"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2008.08.005"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.2490\/prm.20170017"},{"key":"e_1_2_7_14_1","article-title":"High dose amantadine therapy may cause increased falling in patients with Parkinson's disease: a case report","volume":"3","author":"Dames B","year":"2020","journal-title":"Clin Park Relat Disord"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.2803"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2007.07.015"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-198814010-00003"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.13828","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T12:28:01Z","timestamp":1760963281000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.13828"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,14]]},"references-count":16,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1002\/mdc3.13828"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.13828","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,14]]},"assertion":[{"value":"2023-04-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}