Dyskinesia is a movement disorder which consists of adverse effects including diminished voluntary movements[1] and the presence of involuntary movements, similar to tics or chorea. Dyskinesia can be anything from a slight tremor of the hands to uncontrollable movement of, most commonly, the upper body but can also be seen in the lower extremities. Discoordination can also occur internally especially with the respiratory muscles and it often goes unrecognized.[2] Dyskinesia is a symptom of several medical disorders and is distinguished by the underlying cause.
Acute dystonia is a cerebral type of palsy.
Levodopa-induced dyskinesia (LID) is evident in patients with Parkinson's disease who have been on levodopa for prolonged periods of time. LID commonly first appears in the foot, on the most affected side of the body. There are three main types that can be classified on the basis of their course and clinical presentation following an oral dose of L-dopa:[3][4]
- Off-period dystonia - correlated to the akinesia that occurs before the full effect of L-dopa sets in, when the plasma levels of L-dopa are low. It generally occurs as painful spasms in the foot. They will respond to L-dopa therapy.[3][4]
- Diphasic dyskinesia - occurs when plasma levodopa levels are rising or falling. This form tends to predominate in lower limbs, and is usually dystonic or ballistic. It does not respond to L-dopa reduction.[3][4]
- Peak-dose dyskinesia - the most common form of LID; it correlates with the plateau L-dopa plasma level. This type usually involves the upper limbs more (but could also affect the head, trunk and respiratory muscles), is choreic, and less disabling. They will respond to L-dopa reduction but may be accompanied by deterioration of parkinsonism.[3][4] Peak-dose Levodopa-induced dyskinesia has recently been suggested to be associated with cortical dysregulation of dopamine signaling.[5]
Chronic/tardive [edit]
Late onset dyskinesia, also known as tardive dyskinesia, occurs after treatment with an antipsychotic drug such as haloperidol (Haldol) or amoxapine (Asendin). The symptoms include tremors and writhing movements of the body and limbs and abnormal movements in the face, mouth, and tongue, including involuntary lip smacking, repetitive pouting of the lips, and tongue protrusions.[6]
Rabbit syndrome is another type of chronic dyskinesia, while orofacial dyskinesia may be related to persistent replication of Herpes Simplex Virus type-1 (Gonzales GR, 1992)
Non-motor [edit]
Two other types, primary ciliary dyskinesia, and biliary dyskinesia, are caused by specific kinds of ineffective movement of the body, and are not movement disorders. Spastic thrusting of hip area can occur in sodemytopic Parkinson's.
See also [edit]
References [edit]
- ^ "dyskinesia" at Dorland's Medical Dictionary
- ^ David Healy (3 December 2008). Psychiatric Drugs Explained. Elsevier Health Sciences. pp. 29–30. ISBN 978-0-7020-2997-4. Retrieved 16 December 2010.
- ^ a b c d Fabbrini, Giovanni; Brotchie JM, Grandas F, Nomoto M, Goetz CG (2007). "Levodopa-induced dyskinesias". Movement Disorders 22 (10): 1379–1389. Retrieved 2 May 2012.
- ^ a b c d Thanvi, Bhomraj; Lo N., Robinson T. (2007). "Levodopa-induced dyskinesia in Parkinson's disease: clinical features, pathogenesis, prevention and treatment". Postgraduate Medical Journal 83: 384–388. doi:10.1136/pgmj.2006.054759. Retrieved 28 April 2012.
- ^ M.Tamtè/P.Halje; U.Richter, M.Mohammed, A.Cenci, P.Petersson (November 2012). "Levodopa-induced dyskinesia is strongly associated with resonant cortical oscillations". Journal of Neuroscience, 32 (47): 16541–16551. PMID 23175810.
- ^ David Healy (3 December 2008). Psychiatric Drugs Explained. Elsevier Health Sciences. pp. 30–31. ISBN 978-0-7020-2997-4. Retrieved 16 December 2010.
