A right-handed 56-year-old man presented with concern for Parkinson’s disease given father’s history of PD, hyposmia, and worsening arm spasms for 6 years.  The spasms were only with writing and present for 3 decades.  Exam at presentation (2013) showed only writer’s cramp on the right limb: dystonic finger posturing on the right hand with wrist flexion and finger flexion.  Levodopa trial was ineffective. Treatment with botulinum toxin injection initially helped but were stopped after 2 years due to intolerable weakness.  In 2020 he reported that the dystonia was spontaneously improving; one year later he stated that it was completely gone.  Over the same period he had increase in reported sleep-enactment behavior but still did not meet the threshold to clinically diagnose PD until 2022, with right-sided bradykinesia, rigidity, and rest tremor.