Dyskinesia is uncontrolled, involuntary movement that may occur with long-term levodopa use and longer time with Parkinson’s. Not everyone will develop this complication, and the experience of dyskinesia varies. New and emerging treatments aim to help avoid dyskinesia.
Dyskinesia can affect one body part, such as an arm, leg or the head, or it can spread over the entire body. Dyskinesia can look like fidgeting, writhing, wriggling, head bobbing or body swaying. It doesn’t happen in everyone with Parkinson’s, and in those who do have it, it occurs to different degrees of severity. In some people, dyskinesia may be painful or bothersome to the point that it interferes with exercise, social life or other daily activities. Many people, though, say they prefer having dyskinesia to being rigid or less mobile due to Parkinson’s.
Dyskinesia tends to occur most often during times when other Parkinson’s symptoms, such as tremor, slowness and stiffness, are well controlled. (This is what doctors and researchers call “on” with dyskinesia.) Stress or excitement can exacerbate dyskinesia.
Management of Dyskinesia
If you experience bothersome dyskinesia, you can discuss several treatment options with your personal physician:
- Changing your levodopa dosage and/or how often it’s taken so you get enough in each dose to control your symptoms but not too much that it causes dyskinesia.
- Switching to an extended-release formulation or continuous infusion of levodopa, which aims to keep the level of medication and therefore dopamine in your system more constant to control symptoms and limit dyskinesia.
- Adding a medication called amantadine to target dyskinesia. Extended-release amantadine was approved to treat dyskinesia in August 2017. (Prior to that, an immediate-release formulation of amantadine, which still may be used in some cases, was available for many years.) Read more about amantadine, levodopa and other Parkinson’s medications.
- Undergoing deep brain stimulation (DBS), a surgical procedure. This is not an option for everyone, but for those who’ve had Parkinson’s for at least four years, still benefit from medication, and have dyskinesia and motor fluctuations (significant “off” times, when medication is not working optimally to control symptoms), DBS may be a consideration.