Dyskinesia is a condition where my muscles move on their own, and I have no control over them. These movements can happen in parts of my body. For example, dyskinesia can occur in my face, tongue, arms, or legs. Sometimes I get Dyskinesia because I have been taking Levodopa medicine for a while to treat my Parkinson’s disease. Levodopa medicine really helps people with Parkinson’s disease. Dyskinesia can also happen if I take medicines. Some people get Dyskinesia because they have Huntington’s disease. Huntington’s disease is a health problem that you are born with. Other health problems that affect how my body works can also cause Dyskinesia. To make Dyskinesia better, my treatment depends on what’s causing my Dyskinesia. The treatment for my Dyskinesia is different from person to person because everyone’s Dyskinesia is different. My Dyskinesia treatment is based on the cause of my Dyskinesia, so my doctor will treat my Dyskinesia based on what’s causing my Dyskinesia.
What are the main types of dyskinesia?
Dyskinesia is not a disease; it is a group of movement problems that people have. These movement problems have one thing in common: they happen without us being in control of our dyskinesia movements. We have dyskinesia because of dyskinesia. The common type of dyskinesia is levodopa-induced dyskinesia. A lot of people with Parkinson’s disease have this type of dyskinesia. In fact, 40 to 50 per cent of them have dyskinesia problems like this. Dyskinesia usually starts after they have been taking medication for a time, like 5 to 10 years. The medicine helps with shaking, but then it causes dyskinesia movements. In some cases, people with dyskinesia may need to see a Neurosurgeon for help with their dyskinesia problems. They may need brain stimulation when the medicine does not help enough with their dyskinesia. There is another type of dyskinesia that usually appears after people take medicines like Risperidone for months or years. People with this type of dyskinesia do things like smack their lips because of the dyskinesia. They stick out their tongue because of dyskinesia movements. They make faces over and over because of dyskinesia. Some people are born with dyskinesia as part of a problem like Huntington’s disease or Wilson’s disease. There is another type of dyskinesia that’s not as common it happens suddenly. It is triggered by things like movement, stress or drinking caffeine. This type is also called dyskinesia or paroxysmal dyskinesia.
What causes dyskinesia?
Medication is usually the cause. Levodopa makes dopamine levels in the brain go up and down a lot, and when they get too high, it can cause movements.
* Antipsychotics work differently: they block dopamine receptors. Over time, those receptors get too sensitive, which leads to tardive dyskinesia. A doctor, a Neurologist, can figure out which medication is causing the problem by looking at a timeline of doses, reviewing medications, and checking movements. Besides medication, dyskinesia can be caused by disorders that affect the part of the brain that controls movement, such as:
- Huntington’s disease
- Wilson’s disease
- Some mitochondrial disorders
Other causes include:
* Stroke
* brain injury
* Brain tumours
* Infections in the central nervous system
Some anti-nausea medications, like metoclopramide, can also cause dyskinesia if taken for a long time.
What are the symptoms of dyskinesia?
The symptoms of this condition really depend on the type you have. Which parts of your body are affected? For example, Chorea is when you have dance movements in your limbs and face that you cannot control. Dystonia is when your body gets stuck in certain positions. Athetosis is a weird movement, usually in your hands, that looks like you are writhing. Tics are like little jerks that you cannot stop. A lot of people have a mix of these movements.
When you take Levodopa and get dyskinesia, the weird movements usually start an hour or two after you take the medicine. They get worse when the medicine is at its strongest in your body. Then they get better when the medicine starts to wear off. With dyskinesia, your face is usually affected the most: your tongue rolls around, you purse your lips, and you chew repeatedly. Sometimes you might also tap your fingers. Rock your body. These movements can be really embarrassing when you are around people; they can make you very tired, and in bad cases, they can even make it hard for you to eat, talk, and walk.
Types of dyskinesia at a glance
| Type | Main cause | Typical symptoms | First-line treatment |
| Levodopa-induced | Long-term PD medication | Chorea in limbs and trunk | Adjust levodopa, add amantadine |
| Tardive dyskinesia | Antipsychotics, antiemetics | Lip smacking, tongue protrusion | VMAT2 inhibitors |
| Huntington’s chorea | Genetic | Chorea, cognitive decline | Tetrabenazine, supportive care |
| Paroxysmal | Genetic or idiopathic | Episodic dystonia or chorea | Carbamazepine, trigger avoidance |
| Wilson’s disease | Genetic copper buildup | Tremor, dystonia, liver issues | Copper chelation |
How is dyskinesia diagnosed?
The symptoms of this condition really depend on the type you have. Which parts of your body are affected? For example, Chorea is when you have dance movements in your limbs and face that you cannot control. Dystonia is when your body gets stuck in certain positions. Athetosis is a weird movement, usually in your hands, that looks like you are writhing. Tics are like little jerks that you cannot stop. A lot of people have a mix of these movements.
When you take Levodopa and get dyskinesia, the weird movements usually start an hour or two after you take the medicine. They get worse when the medicine is at its strongest in your body. Then they get better when the medicine starts to wear off. With dyskinesia, your face is usually affected the most: your tongue rolls around, you purse your lips, and you chew repeatedly. Sometimes you might also tap your fingers. Rock your body. These movements can be really embarrassing when you are around people; they can make you very tired, and in bad cases, they can even make it hard for you to eat, talk, and walk.
How is dyskinesia treated?
Treatment depends on the cause.
For levodopa-induced dyskinesia, the first step is to reduce the dose. You can also switch to a form of the medicine that releases slowly. You can add amantadine. This is the medicine approved just for this condition. If changing the medicine does not work, a special kind of surgery called brain stimulation can help. It targets areas of the brain called the nucleus or the globus pallidus. This can really help some patients. For dyskinesia, the best thing to do is to stop taking the medicine that is causing it. If you can’t stop taking it, you can switch to a medicine that is less likely to cause it. There are medicines called VMAT2 inhibitors. Examples include valbenazine and deutetrabenazine. These are now the choice for treatment. They can really help within a week. For Huntington’s chorea, tetrabenazine is the medicine usually given. Wilson’s disease is treated with copper chelation. This helps remove copper from the body. For dystonia that affects a specific muscle group, botulinum toxin injections can help. This can be used for muscles in the eyelids, neck or hand.
Can dyskinesia be prevented?
Parkinson’s disease is a condition that can cause some problems. When people have Parkinson’s, doctors try to use the amount of levodopa that will work. They also like to start dopamine agonists, especially in younger people with Parkinson’s. They like to use a special kind of medicine that releases the dose over a long time. This helps to delay the start of dyskinesia, which is a problem that people with Parkinsons can get.
With various kinds of medicines, like antipsychotics, doctors try to use the smallest amount that will work too. They like to use various kinds of antipsychotics when they can. They like to check on people every few months to see if they are getting a problem called tardive dyskinesia. If they catch it early, they can do something about it.
There are some kinds of dyskinesia that are passed down from family members. These kinds of dyskinesia cannot be prevented. If doctors can find out about the problem early, they can start to help the person feel better sooner. This is because they can start to manage the symptoms of Parkinson’s. Managing the symptoms of Parkinson’s means helping to control the problems that Parkinson’s causes.
FAQs
Is dyskinesia permanent?
Some types of dyskinesia can go away if you change your medication.
Others can stay with you forever.
If you have dyskinesia, it can become permanent if doctors do not catch it early.
Is dyskinesia the same as dystonia?
No, they are not the same.
Dystonia is a type of dyskinesia where your muscles get stuck in one position.
Dyskinesia is a term that includes all movements that you cannot control.
Can dyskinesia get worse over time?
Yes, it can.
Levodopa-induced dyskinesia and dyskinesia related to Huntingtons disease can get worse as time goes on.
Tardive dyskinesia can also get worse if you do not get treatment.
Does stress make dyskinesia worse?
Yes, it does. Stress, being tired, and drinking too much caffeine can make most types of dyskinesia worse.