Cranio-cervical and limb dystonia, bradykinesia, and postural instability were not responsive to L-dopa, observed.[63] Motor dysfunction remains fixed over time, but second episodes of abrupt worsening have been reported by Cook et al.[66] in 58 RDP subjects, 29 with ATP1A3 mutations, and 29 control subjects without mutation. This evidence concerns the gene ATP1A3 and Dystonia.