Dyskinesias

DYSKINESIAS GENERAL ASPECTS

Dyskinesias are abnormal involuntary movements that can affect various parts of the body, including the face, arms, legs and trunk. These movements can be fast, slow, constant or intermittent, and are usually uncoordinated and uncontrollable by the patient.

TYPES OF DYSKINESIAS

• Levodopa-induced dyskinesia: Common in Parkinson’s patients who have been on prolonged levodopa treatment. It typically manifests during the “ON” phases of treatment, when the medication is at its maximum effectiveness.
• Tardive dyskinesia: Associated mainly with chronic use of neuroleptics, which are used to treat psychiatric disorders such as schizophrenia. Symptoms may take months or even years to appear after treatment is initiated. They are characterized by repetitive and purposeless movements, mainly in the face, such as grimacing, tongue movements and lip smacking, although other parts of the body may also be affected.

DIAGNOSIS

Diagnosis of dyskinesias is based on a detailed clinical history and observation of symptoms. Physicians evaluate the involuntary movements and relate them to the patient’s medication history, especially long-term use of antipsychotics or antiparkinsonian drugs.

TREATMENT

Treatment of levodopa-induced dyskinesias and tardive dyskinesias focuses on symptom management and, when possible, modification of the medication regimen responsible for the abnormal movements, and may include medications to control the abnormal movements. In addition, physical and occupational therapy may help improve motor control and coordination.