Dyskinesia in Parkinson’s Disease: Understanding and Effective Treatment Options

Dyskinesia and Parkinson's is a movement problem that happens to some people with Parkinson's disease dyskinesia, usually after years of treatment with levodopa. It causes uncontrolled, jerky movements that can affect arms, legs, or other parts of the body. It’s not a symptom of Parkinson’s itself but a side effect of long-term medication use. 

Not everyone with dyskinesia and Parkinson's may have this condition. Managing dyskinesia means finding the right balance between controlling Parkinson’s symptoms and avoiding extra movements. People often work with doctors to adjust medications, try new therapies, or add exercises to manage Parkinson's disease dyskinesia better.

Understanding Dyskinesia in Parkinson's Disease

Dyskinesia in Parkinson's disease refers to movements that are involuntary and uncontrollable, which frequently develop after long-term use of levodopa. These movements can affect the arms, legs, face, or torso. Since dyskinesia and Parkinson's are linked to medication rather than the disease itself. Dyskinesia isn’t a symptom of Parkinson’s itself but happens due to long-term medication use and changes in brain chemistry over time.

How Dyskinesia Affects Parkinson’s Patients

• Causes unwanted, uncontrolled movements that can interrupt daily life.
• Movements show up when medication is working well (during “on” times).
• Makes simple tasks like eating, writing, or walking harder.
• It can make people feel self-conscious in public.
• Often gets worse with more years on levodopa.
• Doesn’t cause pain directly, but constant movement can lead to tiredness or soreness.

Common Symptoms of Dyskinesia in Parkinson’s Disease

• Jerky, twisting or wriggling movements in arms, legs, or face.
• Movements can be small or very noticeable.
• Happens more when medication is active in the body.
• It can affect balance and coordination.
• It might feel like restlessness or the need to move.
• Usually, it stops or slows down during sleep or deep rest.

Causes and Risk Factors of Dyskinesia in Parkinson’s

The main cause of Parkinson's disease dyskinesia is the usage of levodopa for long periods of time. This can be a result of overuse or using doses more than recommended. In some cases, it can happen when there is a change to the brain function and it reacts to the usage of levodopa.

Key Causes of Dyskinesia in Parkinson’s Patients

Dyskinesia happens mostly because of long-term levodopa use. Over time, the brain handles dopamine differently, causing extra movements when medication kicks in. It’s not the disease itself causing dyskinesia- it’s the way Parkinson’s medications interact with brain changes.

Risk Factors for Dyskinesia in Parkinson’s Disease

Starting levodopa at a younger age raises dyskinesia Parkinson risk. Longer treatment time also increases the chances. Higher medication doses make symptoms more likely. Other factors, like severe Parkinson’s symptoms or being underweight, can add to the risk. 

Dyskinesia in Advanced Stages of Parkinson’s

Dyskinesia can worsen in people in advanced stages of Parkinson’s and has a cascading effect on their mobility and health.

How Advanced Parkinson’s Disease Increases Dyskinesia Risk

As Parkinson’s progresses, brain cells handling dopamine keep breaking down. The longer you use levodopa, the harder it gets for the brain to handle the ups and downs of medication. The advanced disease also means bigger medication doses, which can trigger more movement problems.

Managing Dyskinesia in Late-Stage Parkinson’s

Doctors frequently adjust when medications are taken, reduce dosages, or incorporate additional drugs to enhance the overall effects of the treatment. Some people try advanced treatments like deep brain stimulation. It is important to combine medication changes with exercise, relaxation techniques, and staying active.

Support Strategies for Patients and Caregivers

Tracking movements, meds, and daily patterns help spot triggers, especially when done by caregivers. This has to be followed by regular check-ins with doctors to keep treatments on track. Open communication between the caregivers and the individuals can keep a check on the condition and its impact on a day-to-day basis.

Treatment Options for Dyskinesia in Parkinson’s

There are several ways to treat dyskinesia, depending on the condition and the individual's preference. A combination of medication, physical therapy and alternative remedies can be considered.

Pharmacological Treatments for Dyskinesia in Parkinson’s

Medication is an important treatment plan as it can help manage the dosage and impact of levodopa on the individual for Parkinson's disease dyskinesia.

Levodopa Adjustments

One of the most important changes is to tweak levodopa by lowering doses, spreading them out, or adding slow-release forms. The goal is to reduce peaks and valleys in dopamine levels, which trigger dyskinesia.

Amantadine

Doctors commonly recommend amantadine to help with dyskinesia. It has a different mechanism than levodopa, as it lessens involuntary movements while still providing relief from Parkinson's symptoms. Typically, it’s introduced when adjusting the medication dosage alone isn’t enough to manage dyskinesia effectively.

Other Medications

Some individuals use dopamine agonists, COMT inhibitors, or MAO-B inhibitors to adjust how the body handles dopamine. These medications help smooth out medication effects, reducing the risk of big dopamine spikes that can trigger dyskinesia Parkinson's after taking levodopa.

Surgical Interventions for Dyskinesia in Parkinson’s

There are surgical options for treating the condition, which are considered only in extreme cases or when other treatments are not effective.

Deep Brain Stimulation (DBS)

Doctors place electrodes in specific brain areas to help control abnormal signals causing dyskinesia. A small device sends electrical pulses to these areas, helping reduce extra movements caused by medication.

Other Surgical Options

There are also lesioning procedures, such as pallidotomy, which destroys a tiny part of the brain that controls movement. These surgeries aim to reduce severe dyskinesia parkinson when medications and adjustments no longer work well for symptom management.

Emerging Treatments and Research for Dyskinesia in Parkinson’s

Like any condition, new research and cutting-edge technology are changing and defining treatment for Parkinson's. Access to these innovations varies based on country and economic conditions, but knowing about them can help understand new possibilities in treatment.

New Medications Under Investigation

Researchers are testing drugs that target brain chemicals linked to dyskinesia. Some focus on smoothing dopamine delivery, while others block receptors involved in abnormal movements. These medications are still in trials, so they’re not part of standard treatment yet.

Advances in Surgical Techniques

Surgeons are improving how they place electrodes for DBS, using better imaging and mapping tools. New techniques aim to make surgeries faster, safer, and more precise. Researchers are also exploring non-invasive brain stimulation as a possible future option.

Lifestyle and Non-Pharmacological Strategies for Dyskinesia in Parkinson’s

Small lifestyle changes and consistency can go a long way in managing the condition and treating it. These alternatives help in reducing the dependence on medication and can improve quality of life.

Physical Therapy 

• Physical therapy is designed to help in balance training to prevent fall
• Gait training to improve walking
• Strength exercises to support muscles. 
• Stretching exercises are designed to reduce stiffness
• Functional exercises make everyday tasks easier.

Some of the exercises can be done at home, while some may need expert assistance and supervision.

Dietary Considerations

Healthy food and diet that compensate for nerve dysfunction or straighten it is important. Food that is rich in fibre helps in digestion, antioxidant-rich fruits and vegetables, and omega-3 sources for brain health. Timing protein intake helps medication work better. Staying hydrated also supports energy and digestion.

Stress Management 

• Stress management activities such as meditation, deep breathing, and gentle movements like yoga or tai chi help manage stress and anxiety. 
• Join support groups that can help you share feelings and tips. 
• Hobbies like art, music, or gardening provide calm. 
• Regular social time with friends or family also helps ease stress. This can create a sense of a positive community and help understand that the person is not alone in managing their condition.

Managing Dyskinesia in Parkinson’s: Practical Tips

Simple hacks at home can help reduce the intensity of dyskinesia. Small adjustments to lifestyle, eating better and keeping a check on the dosage and usage of levodopa can reduce its severity.

Daily Living Adjustments

Break tasks into smaller steps to make movement easier. Use tools like wide-grip utensils or button hooks for dressing. Create a calm, clutter-free space to avoid falls. Plan activities for times when medication works best. Rest when needed to avoid fatigue.

Support Resources

Join Parkinson’s support groups to share advice and encouragement, which can help understand the condition better. Get your loved ones to attend them. Connect with physical therapists, occupational therapists, or counsellors for guidance. Caregiver support groups also help families manage challenges together and find helpful coping strategies.

Managing Dyskinesia in Parkinson's Disease with the Help of Physiotattva

At Cadabam’s Physiotattava, our goal is to help you break down the complexities of the condition and find the right treatment for you. We work closely with several healthcare providers who bring years of experience and a transdisciplinary approach to the treatment. This ensures you get the best care possible. Drop us a call today.

At Physiotattva physiotherapy clinics in Bangalore and Hyderabad, you receive personalised care tailored to your specific needs, ensuring effective results and comfort throughout your journey to recovery. 

Don’t wait to start your recovery! Get in touch with Physiotattva for more details! Contact us at +91 89510 47001.

FAQs

What is dyskinesia in Parkinson’s disease?

Dyskinesia means involuntary, uncontrolled movements that happen after years of Parkinson’s treatment, usually from long-term levodopa use. It’s not a symptom of Parkinson’s itself but a side effect of the medication, causing twisting, jerking, or writhing movements in different body parts.

What is the finger test for Parkinson’s?

The finger test checks for slow or stiff movements, which are common in Parkinson’s. Doctors ask you to tap your thumb and index finger together quickly. In Parkinson’s, tapping may become slow, uneven, or stiff, helping doctors spot early movement issues.

Is dyskinesia the same as Parkinson’s?

No, dyskinesia isn’t the same as Parkinson’s. Parkinson’s causes tremors, stiffness, and slowness, while dyskinesia is a side effect of long-term medication use. It’s caused by changes in how the brain handles dopamine from Parkinson’s drugs, not from the disease itself.

What medication is used for Parkinson’s dyskinesia?

Amantadine is commonly used for dyskinesia in Parkinson’s. Doctors might also adjust levodopa dosing or add medications like dopamine agonists or COMT inhibitors to smooth dopamine levels and reduce movement issues caused by medication peaks and dips.