Paradoxical Suppression of Chorea by Apomorphine

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Abstract
To the Editor.— Choreiform movements in a variety of clinical syndromes appear to be physiologically related to abnormal functions of the corpus striatum. It has been recently proposed that increased responsiveness of striatal dopamine (DA) receptors to DA underlies these abnormal movements.1 To further delineate the role of DA in the production of chorea we administered apomorphine (subcutaneously) in doses of 1 to 2 mg, and placebo in similar doses, to five patients: two with tardive dyskinesias, two with spontaneous orofacial dyskinesias, and one patient with congenital choreoathetosis. In four of the five patients, a moderate to marked, though transie.it (45 to 80 minutes), reduction of choreiform movements was observed after apomorphine administration, while little change in abnormal movements was noted after placebo injections. One patient with spontaneous dyskinesias did not show any improvement in chorea. Side effects such as nausea and vomiting, hypotension, or sedation occurred in all