Levodopa-Induced Oculogyric Crisis in Multiple System Atrophy

Oculogyric crisis (OGC; also referred to as oculogyric spasm) is a rare movement disorder characterized by tonic conjugate eye deviation, typically upward, with preserved consciousness.Associated features include blepharospasm, cervical dystonia, autonomic manifestations (pupillary dilation, lacrimation), and psychiatric symptoms (anxiety, agitation) 1 .Levodopainduced OGC (LI-OGC) represents sustained tonic deviation, typically appearing 10-30 minutes post-dose, associated with patient awareness and distress 2,3 .On the other hand, levodopa-induced ocular dyskinesia (LIOD) differs fundamentally: brief phasic eye deviations lasting seconds, with patients usually unaware and untroubled by the movements 3 .