Dyskinesia is the involuntary movement of several body parts such as the head, arms or in some instances the entire body. Dyskinesia can have potentially adverse effects on the normal lifestyle of an individual, leading to reduced quality of life. The severity and frequency of dyskinesia may vary from person to person and can be severe or mild. Dyskinesia is generally observed in patients of Parkinson’s disease (PD) when the disease is advancing. Around 40-50% of PD patients will develop dyskinesia after five years of treatment.

Symptoms
Dyskinesia symptoms are individual specific and can vary from slight or mild movements of some body parts to severe where the entire body shows involuntary movements. Some common symptoms of dyskinesia are twitching, restlessness, wriggling, and body swaying. Dyskinesia can make a person weak, exhausted, fatigued and cause weight loss. It also increases the vulnerability of the patients towards injury and accidents.

Causes
One of the most common causes of dyskinesia is the prolonged use of levodopa, a medication often used in the treatment of PD.

  • Brain cells normally utilize an amino acid called tyrosine to make levodopa, which is then converted to dopamine. Dopamine neurotransmitter plays a central role in body movements.
  • People with PD have reduced levels of dopamine in their brains due to deficiency of dopamine-producing neurons. Thus, levodopa is provided to PD patients to normalize the dopamine levels artificially.
  • Although levodopa raises the dopamine levels in the brain, it is difficult to maintain the constant and uniform levels of dopamine with the help of levodopa.
  • This causes a situation of cyclic ups-and-downs in the concentration of dopamine, which is a triggering factor for dyskinesia.
  • It is interesting to note that every patient undergoing levodopa treatment does not have the same severity of symptoms and every patient with levodopa therapy does not develop dyskinesia.

Typically, as the PD advances and the severity of the symptoms increases, levodopa dosage is increased for management of the disease. However, higher dosage also causes higher fluctuations in dopamine levels, leading to worsened dyskinesia. Reducing the dosage does not help either because it causes poor PD control. In some cases, dyskinesia also develops due to side effects of certain antipsychotic drugs (called tardive dyskinesia).

Treatment for the disease
Generally, dyskinesia treatment is individual specific and depends on several factors such as age, severity, and duration of levodopa treatment. The following strategies are generally employed by specialists.

  • They adjust the drug dosage to avoid large fluctuations in the drug concentration.
  • They suggest smaller dosage with higher frequency.
  • Stress exacerbates dyskinesia symptoms. Thus, stress management is another way to control it.

Dyskinesia is a movement disorder that develops due to side effects of levodopa, a frequently used medicine for PD treatment. An individual with dyskinesia lives a compromised life. The proper management of the disease essentially requires an adjustment in both lifestyle and drug dosage.