The diagnostic dilemma of Parkinson's disease as a cause of calf 'claudication'.

INTRODUCTION A recognised feature of Parkinson’s disease is the presence of muscle cramps. These are often attributed to dopaminomimetic medications and are known as early morning dystonia or ‘off’ dystonia. While these usually affect the truncal and upper limb musculature, patients can occasionally present with cramp-like calf pains which are frequently worse at night. The symptoms may be confused with those of peripheral vascular disease and these patients may therefore pose a diagnostic dilemma to examining and referring clinicians.