Table of ContentsView AllTable of ContentsDefinitionSymptomsCausesDiagnosisTreatmentManagement

Table of ContentsView All

View All

Table of Contents

Definition

Symptoms

Causes

Diagnosis

Treatment

Management

Learn about the different types of dyskinesias, symptoms, risks, and treatment options. Also, learn about conditions similar to dyskinesias and some methods to manage life after diagnosis.

What Is Dyskinesia?

There are different types of dyskinesias which lead to different symptoms as well as treatments. Common types of dyskinesias include:

Oftentimes, related conditions likedystonias,stereotypies, and tics are included as dyskinesias. However, characterizing some of these other movement disorders as dyskinesias remains a topic of debate among medical professionals.

Verywell / Cindy Chung

Dyskinesia Symptoms

Symptoms can vary from person to person and might appear differently depending on the type of dyskinesia diagnosed. They may begin as fine movements calledtremors, or even as tics, and then develop into the common symptoms characteristic of dyskinesia like:

It is notable that restlessness and twitching occur less often in levodopa-induced dyskinesia.

Symptoms can worsen over time gradually or develop suddenly and intensify after a serious brain injury.

Tardive Dyskinesia vs. Dystonia: What Are the Differences?

Chorea movements may be continuous, last a few seconds, or involve sudden, jerking behaviors. These movements most commonly affect the limbs, face, and head.

In cases of athetosis, movements may be slow turning, bending, or writhing and affect fingers, hands, and toes. Athetosis may affect the arms, legs, neck, and tongue of someone diagnosed with the disorder.

Causes of Dyskinesia

Medications

Dyskinesia is commonly seen in people withParkinson’s disease. It is often the result of long-term use of levodopa, resulting in levodopa-induced dyskinesia. However, it can also occur after a few months or days of treatment. Levodopa is the preferred method of treatment for Parkinson’s disease because it’s the most effective.

While scientists are still trying to understand why dyskinesia develops, in levodopa-induced dyskinesia, it is possible that the brain chemical that aids in cell communication,dopamine, plays a role in the development of the movement disorder.

People with Parkinson’s disease experience a loss in the brain cells that create dopamine, decreasing dopamine levels in the brain. Levodopa temporarily restores these dopamine levels. However, because the medication is rapidly metabolized and needs to be taken multiple times a day, dopamine levels remain unsteady and rise and fall.

The fluctuation of dopamine and the continued loss of dopamine-producing brain cells makes it difficult to maintain normal levels, which possibly contributes to dyskinesia. People who are younger at the time of diagnosis of Parkinson’s disease, or those who are prescribed a high dose of levodopa, might be at greater risk for developing dyskinesia.

Generally, changes in the levels of specific brain chemicals—like dopamine, serotonin, and glutamate—are associated with the development of dyskinesia.

Brain Injury and Damage

Generally, if there is an injury to the basal ganglia, an area of the brain responsible for controlling voluntary movements and learned habits, dyskinesia could possibly develop.

How Dyskinesia Is Diagnosed

The different abnormal movements that characterize the distinct types of dyskinesia will generally require the careful observation and clinical judgment of aneurologistor movement disorders specialist. The type of movements and areas of the body affected are key in determining the proper diagnosis. Assessing the impact of the condition may require the use of anabnormal involuntary movement scale.

Specifically for levodopa-induced dyskinesia, the control of symptoms associated with Parkinson’s disease (like tremor and stiffness) may be balanced against the gradual development of dyskinesia. Some affected people report preferring to deal with the symptoms of dyskinesia rather than those of Parkinson’s disease.

Dystonias, stereotypies, and tics are additional motor disorders related to dyskinesias.Dystoniasmay cause muscles to tighten and form abnormal sustained or repetitive muscle spasms or abnormal fixed postures. For stereotypies and tics, those people experiencing these motor disorders may have some level of control over the movements, even the ability to reduce them.

Treatment for Dyskinesia

Treatment can vary depending on the type of dyskinesia diagnosed and the individual and may include:

Medication Changes

For levodopa-induced dyskinesia, controlling the dose and the timing of taking levodopa may balance the levels of dopamine and decrease symptoms. Different forms of the medication, such as extended-release Rytary or the gel-infusion Duopa, may also be helpful. An extended-release form of amantadine, called Gocovri, may also help control levels of glutamate in the brain and reduce symptoms.

Deep Brain Stimulation

To control symptoms,deep brain stimulation (DBS)is a surgical procedure that is another treatment option, but it is not right for everyone. Minimum requirements include a diagnosis of Parkinson’s for at least four years, recurrent episodes of dyskinesia, and ongoing responsiveness to and benefit from the use of levodopa in most cases.

Other Therapies

For dyskinesias that impact the facial, neck, and limb region, some patients try injections of Botox, or botulinum toxin, to reduce movement.

There are several additional therapies that are currently undergoing clinical trials for the treatment of dyskinesias. Potential treatments for tardive dyskinesia include melatonin and estrogen, which modulate dopamine-controlled behavior and protect against cell damage from the long-term use of antipsychotic medications.

For the treatment of levodopa-induced dyskinesia, drugs that target different brain chemicals are being studied. In addition, under-the-skin levodopa pumps are also being studied to test if they can effectively maintain consistent dopamine levels.

Finally, researchers are investigating ways to best optimize deep brain stimulation and are testing a technique called focused ultrasound, a non-invasive, irreversible procedure to treat dyskinesia.

Living With Dyskinesia

Dealing with dyskinesias can be stressful and impact daily activities and social interactions. Exercise, like walking or swimming, may be recommended. Managing stress may also be crucial to control symptoms, as stress tends to exacerbate the uncontrolled movements.

Further information and resources may be sought from specialized organizations, like theMichael J. Fox Foundation for Parkinson’s Researchor theGenetic and Rare Disease Information Center. Support groups may also be helpful to manage life with dyskinesia.

Summary

Talk to your practitioner if you believe you are developing symptoms of uncontrolled movements that may be associated with dyskinesia. Make note that while there are several treatment options available, it is important to work with your healthcare provider to determine what may be the best course for your long-term condition management and treatment.

4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pandey S, Srivanitchapoom P.Levodopa-induced dyskinesia: clinical features, pathophysiology, and medical management.Ann Indian Acad Neurol. 2017;20(3):190-198. doi:10.4103/aian.AIAN_239_17Müller T, Möhr JD.Recent clinical advances in pharmacotherapy for levodopa‑induced dyskinesia.Drugs. 2019;79(13):1367-1374. doi:10.1007/s40265-019-01170-5National Organization for Rare Disorders.Tardive dyskinesia.Dougherty, DD.Deep Brain Stimulation–Clinical Application.Psychiatr Clin N Am. 2018 Sep;41(3):385-394. doi:10.1016/j.psc.2018.04.004Additional ReadingMichael J Fox Foundation for Parkinson’s Research.Dyskinesia.

4 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pandey S, Srivanitchapoom P.Levodopa-induced dyskinesia: clinical features, pathophysiology, and medical management.Ann Indian Acad Neurol. 2017;20(3):190-198. doi:10.4103/aian.AIAN_239_17Müller T, Möhr JD.Recent clinical advances in pharmacotherapy for levodopa‑induced dyskinesia.Drugs. 2019;79(13):1367-1374. doi:10.1007/s40265-019-01170-5National Organization for Rare Disorders.Tardive dyskinesia.Dougherty, DD.Deep Brain Stimulation–Clinical Application.Psychiatr Clin N Am. 2018 Sep;41(3):385-394. doi:10.1016/j.psc.2018.04.004Additional ReadingMichael J Fox Foundation for Parkinson’s Research.Dyskinesia.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Pandey S, Srivanitchapoom P.Levodopa-induced dyskinesia: clinical features, pathophysiology, and medical management.Ann Indian Acad Neurol. 2017;20(3):190-198. doi:10.4103/aian.AIAN_239_17Müller T, Möhr JD.Recent clinical advances in pharmacotherapy for levodopa‑induced dyskinesia.Drugs. 2019;79(13):1367-1374. doi:10.1007/s40265-019-01170-5National Organization for Rare Disorders.Tardive dyskinesia.Dougherty, DD.Deep Brain Stimulation–Clinical Application.Psychiatr Clin N Am. 2018 Sep;41(3):385-394. doi:10.1016/j.psc.2018.04.004

Pandey S, Srivanitchapoom P.Levodopa-induced dyskinesia: clinical features, pathophysiology, and medical management.Ann Indian Acad Neurol. 2017;20(3):190-198. doi:10.4103/aian.AIAN_239_17

Müller T, Möhr JD.Recent clinical advances in pharmacotherapy for levodopa‑induced dyskinesia.Drugs. 2019;79(13):1367-1374. doi:10.1007/s40265-019-01170-5

National Organization for Rare Disorders.Tardive dyskinesia.

Dougherty, DD.Deep Brain Stimulation–Clinical Application.Psychiatr Clin N Am. 2018 Sep;41(3):385-394. doi:10.1016/j.psc.2018.04.004

Michael J Fox Foundation for Parkinson’s Research.Dyskinesia.

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