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Department of Neurology, Santa Clara Valley Medical Center, and Institute for Medical Research, San Jose, CA.
Seven patients developed chronic and severe parkinsonism after repeatedly injecting 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) intravenously. Levodopa and bromocriptine controlled the symptoms; however, within months, five of the seven patients experienced dyskinesias or on-off fluctuations. Therefore, neither prolonged levodopa treatment nor progressive disease was necessary for on-off phenomena. Because the neurotoxic effects of MPTP seem limited to the substantia nigra, damage to this system alone may produce all the motor features of Parkinson's disease. MPTP differs from other neurotoxins in that it consistently produces a pure parkinsonian state.
Address correspondence and reprint requests to Dr. Langston, Department of Neurology, Santa Clara Valley Medical Center, 751 South Bascom Avenue, San Jose, CA 95128.
Supported in part by the Retirement Research Foundation and a fellowship (to Phillip Ballard) from the Santa Clara County Mental Health Services.
Accepted for publication October 24, 1984.
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