Dyskinesia

09/07/2011

Motor Complications- Dyskinesia.

Dyskinesia are a caused by medicines used to treat movement symptoms of Parkinson's disease. These involuntary movements often accompany on-off fluctuations.

Initially, symptoms are smoothly controlled with medication throughout the day. However, movement control with medical treatment can become more difficult as time progresses. These problems first appear as motor fluctuations often referred to as on and off fluctuations or periods. On - Off periods describe the change throughout the day in response to medication. On is when the medicine improves symptoms. Off is when the medicine effect is worn off or is no longer working and symptoms worsen or return.

Dyskinesia or involuntary (unintentional) movements or jerky motions is a side effect of dopaminergic medication and usually occurs in the setting of levodopa use. Factors that increase a person's risk of experiencing dyskinesia include:

   Younger age
   Advanced disease
   Total dose of levodopa
   Amount of other dopaminergic medicines taken throughout the day

Types of dyskinesia
Peak dose dyskinesia - involuntary movements that occur when levodopa are at 'peak blood levels' . This typically occurs 30 to 90 minutes after a dose of levodopa.

Diphasic Dyskinesia - involuntary movements that occurs just after a person takes levodopa or as a wearing effect prior to the next dose.

Choreiform dyskinesia - refers to a type of involuntary movement. Unlike dystonic dyskinesia, these movements are in constant motion such as twitching (not to be confused with tremor), jerking or irregular rhythmic movements of any part of the body.

Dystonic dyskinesia - refers to the type of involuntary movement. These movements are defined as a sustained and excessive muscle contraction which leads to twisting (such as the neck or spine), spasm (such as facial spasm) or bending (such as hand, foot or elbow flexion).

Treatment of dyskinesia
Medication reduction, smaller but more frequent dosing of pills, amantadine and Deep Brain Stimulation (DBS) surgery are examples of treatments that can improve dyskinesia. Since each person is different, a consultation with your provider is necessary to know which is right for you.

See section on PD symptoms for more information.

Author: Monique Giroux, MD

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