Dyskinesia is when one or multiple parts of the body make movements involuntarily. It’s often seen in people with Parkinson’s disease and can be a side effect of levodopa treatment.
Read on to learn about dyskinesia and its types.
“Dyskinesia” is a blanket term to describe uncontrollable and involuntary movements. It’s when your body moves in ways you cannot control. It can affect just one part of the body, like the head or an arm, or your entire body.
Dyskinesia can range from mild to severe. It can sometimes interfere with typical daily activities. It can also differ in the frequency and the time of day it occurs.
There are many types of dyskinesia with various causes. That said, often the term “dyskinesia” is used to refer specifically to levodopa-induced dyskinesia (LID).
LID is a form of dyskinesia sometimes seen in people with Parkinson’s disease, typically as a side effect of long-term levodopa treatment.
The types of dyskinesia include:
Parkinson’s disease dyskinesia
If taking levodopa is causing dyskinesia, it’s called
Levodopa is a medication used to treat Parkinson’s disease. Levodopa acts like dopamine. It can sometimes create an environment where there’s too much or too little dopamine in the body. This can cause uncontrollable movements.
LID occurs in two subtypes:
- Peak dose dyskinesia: This is when symptoms develop when the concentration of levodopa in your blood is highest, most commonly 1–2 hours after you take it.
- Diphasic dyskinesia: With levodopa, you have an “on period” when you’re taking the medication. You also have an “off period” when you take a break from it. When dyskinesia symptoms develop when you start to take it or phase it out, it’s called diphasic dyskinesia or dyskinesia-improvement-dyskinesia (D-I-D) syndrome.
Tardive dyskinesia
TD usually goes away once you stop taking that specific medication, but it can sometimes last for many years.
Additional types
A few other conditions can be considered a type of dyskinesia. These include:
- Chorea: Chorea is a type of dyskinesia causing sudden, irregular movement of the limbs, head, and face. It
usually occurs on one side of the body at a time, but it may switch randomly between both sides. It can also occur as part of TD. When chorea is very severe, it’s known as ballism. - Dystonia: This
can be considered a type of dyskinesia. However, instead of involuntary movements, dystonia causes your muscles to contract when you’re not trying to move them. These spasms can last for a long time and lead to uncomfortable postures that can be painful. - Athetosis: This typically affects the hands and feet, causing them to writhe in slow, wriggling movements. It can be similar to chorea and dystonia in its symptoms.
- Tremors: Rhythmic contractions of muscles are known as
tremors . When someone is not actively using the body part affected by the tremor, the tremor can be referred to as resting or static. Kinetic tremors usually occur when you attempt to move a limb, usually an arm or hand. Postural tremors occur when trying to maintain a position against gravity, like if you’re holding your arms outstretched. - Myoclonus: This refers to sudden, often repetitive, involuntary muscle spasms and jerks. A disruption of the central nervous system or a nerve injury usually triggers it. Myoclonus is also a type of simple tic. Other tics can be vocal or involve more complex, involuntary actions.
The symptoms of dyskinesia
Some symptoms of dyskinesia may look like:
- fidgeting
- wriggling
- swaying of the body
- bobbing of the head
- twitching
- restlessness
A
Levodopa increases the level of dopamine in the brain. People with Parkinson’s lack dopamine-producing brain cells. Levodopa replaces dopamine for people with Parkinson’s disease and other conditions that involve low levels of dopamine.
However, your dopamine levels will rise when you take levodopa and fall as the levodopa wears off. Researchers believe these variations in dopamine levels cause the involuntary movements of dyskinesia.
Other causes of dyskinesia, depending on the type, include:
- Huntington’s disease
- Wilson disease
- low blood sugar
- hypothyroidism, which is an underactive thyroid
- Lyme disease and other infections
- other medications for Parkinson’s
- some antihistamine medications
- substance use
- brain causes, like stroke or cancer
- multiple sclerosis
- anti-nausea medications, such as metoclopramide (Reglan and Metozolv ODT)
When dyskinesia is a direct result of taking levodopa, the treatment differs from person to person.
Some treatment options may include:
- adjusting the dose of your levodopa to avoid large fluctuations in the amount of dopamine in your system
- taking levodopa in a continuous infusion or an extended-release formulation
- taking amantadine extended-release (Gocovri), which has been approved to treat dyskinesia
- taking levodopa in smaller doses more often
- taking Duodopa, a gel medication administered through an intestinal pump that helps stabilize the amount of dopamine in the blood, which may help with smoother motor functions
- undergoing deep brain stimulation, which is a surgical treatment for severe symptoms
- Note: Certain criteria must be met for this to be an effective treatment. Ask your doctor whether this is an option for you. Deep brain stimulation is only done after other treatments have not worked.
Therapies in development
Three drugs are currently approved by the Food and Drug Administration (FDA) for treating dyskinesia, especially in cases associated with Huntington’s disease:
In addition, L-4-chlorokynurenine (AV-101) is in clinical trials.
Many therapies are currently in development. However, the challenge for researchers around dyskinesia caused by Parkinson’s medication is that some medications may help people who experience dyskinesia symptoms when their levodopa is the most active in their system.
Other medications may help people who experience symptoms when their medication is almost done being absorbed by the body.
So, currently, it’s unlikely to find a one-size-fits-all therapy.
Treatments for other causes
Other types of dyskinesia have different treatments depending on the underlying cause.
For example, some medications treat myoclonus, depending on what causes it. Botox is a common treatment for dystonia.
Other possible categories of medications and treatments
- steroids
- anticonvulsants
- antibiotics
- plasmapheresis
- surgery
As with any treatment, discuss all side effects with your doctor before deciding on the best treatment for you.
What’s the difference between dyskinesia and tremor?
Although tremor is a type of dyskinesia, the term “dyskinesia” usually refers to levodopa-induced dyskinesia (LID) specifically. LID is a drug side effect.
Tremors can also develop in Parkinson’s disease, but they’re caused by the disease itself and not a medication.
Dyskinesia and tremors both cause involuntary movements, but how their symptoms present varies.
What’s the difference between dystonia and dyskinesia?
Dystonia is a form of dyskinesia. But rather than causing excessive involuntary movements, dystonia causes your muscles to contract or tighten.
Can dyskinesia go away?
Whether or not dyskinesia can go away depends on the cause and available treatments.
When a medication is causing it, stopping the drug can help it go away. Other causes require different treatment.
Therefore, it’s important to talk with your doctor about the various treatment options to help manage dyskinesia if it develops during your treatment.
Is dyskinesia the same as Parkinson’s?
Parkinson’s disease can cause dyskinesia. A medication to treat Parkinson’s can also cause dyskinesia.
“Dyskinesia” is a blanket term used to describe involuntary, uncontrollable movements. It’s routinely seen in people with Parkinson’s disease who have been taking the medication levodopa for a long period.
It can also develop in people taking antipsychotic medications, but in this instance, it’s typically referred to as tardive dyskinesia.
Other types of dyskinesia have different treatments, and treatment decisions will vary from person to person. Talk with your doctor to create a care plan that works for you.