Parkinson's Dyskinesia: You May Not Have to Live With Those Extra Movements

Dyskinesias are abnormal, involuntary movements that occur in response to dopamine-replacement therapy
They can occur with levodopa or agonists
The movements have been described as “choreiform”
Chorea is a word that is derived from the Greek word meaning “to dance”, so the dyskinesias look similar to dance type movements
It can over time with Parkinson's disease become increasingly difficult to find a dose of levodopa that provides symptom relief while avoiding dyskinesia

Go to a Parkinson’s specialist and keep in mind that it may take multiple visits to resolve the issue
Dyskinesia is usually worsened by increasings the dose of levodopa (sinemet) and/or agonist
Reducing the dose, and possibly taking smaller doses more frequent doses may help
Entacapone (Comtan) (which is a component of a medicine called Stalevo) can make dyskinesia worse in some cases
In severe cases, holding a dose or two of sinemet can help to temporarily relieve dyskinesia, but check with your doc as it can also worsen Parkinson symptoms
Stopping sinemet for a day or two can be dangerous so always consult your doctor for prolonged drug holidays
Total drug holidays (stopping all medicines) are no longer recommended by Parkinson experts
Sometimes eliminating dopamine agonists, MAO-B drugs, Comtan (or Stalevo) can be helpful if all other medicine trials have failed to relieve dyskinesia
Using more frequent but lower dosages of sinemet that will allow the patient to feel “on” is a possible treatment
Liquid sinemet is an option, although for most patients this is not a long-term viable strategy (crushing 10 sinemet tablets and placing in 1 liter of ginger ale with a crushed vitamin C tablet)
Amantadine can be added to suppress dyskinesia– and is helpful for some sufferers
Deep brain stimulation and duodopa pumps may be used in severe cases and can be a very powerful treatment for dyskinesia

Michael OkunNovember 18, 2012

To read more on Indu Subramanian M.D. she does live interviews of experts in Parkinson’s for the PMD Alliance. She is one of the few doctors in the world trained in both Parkinson’s disease neurology and in integrative medicine.