Dyskinesia is a health disorder characterized by erratic and involuntary movement of different body parts. In most cases, the movement is dance-like and fluid, but it can also take the form of rapid jerking and slow and extended spasms, depending on the type of dyskinesia and other factors. This article briefly discusses the causes of this health condition, its symptoms, and how dyskinesia can be managed with the help of treatment.

Causes of dyskinesia
Dyskinesia could result from several factors, including brain injury, stroke, vitamin deficiencies, and genetic disorders. However, it is most often a complication of Parkinson’s disease, a severe neurological disorder that affects nearly a million people across the country. But, what causes Parkinson’s disease patients to develop dyskinesia? There is probably only one answer: Levodopa, one of the treatments for Parkinson’s.

If a person has Parkinson’s, the brain cells that produce dopamine (a vital brain chemical) are lost, resulting in low dopamine levels. With levodopa, the dopamine levels are restored temporarily. It falls again once the effect is over, so the patent is given another dose of levodopa. This repeats several times a day, and the levels of dopamine rise and fall, contributing to dyskinesia in Parkinson’s patients. The problem can be severe if a person is diagnosed with Parkinson’s at a very young age because they are exposed to levodopa for years.

So, is Parkinson’s (and thus overuse of levodopa) the only significant contributor to dyskinesia? The answer is no. Another type of dyskinesia, called tardive dyskinesia, results from antipsychotic treatments used to manage conditions like schizophrenia and depression. This type of dyskinesia usually disappears when the treatment is stopped, but it could last for a few years.

Symptoms of dyskinesia
There are different types of dyskinesia, such as tardive, chorea, dystonia, and myoclonus. The symptoms vary depending on the type and even from person to person. The ones common are:

• Wriggling
• Fidgeting
• Swaying of the body
• Bobbing of the head (almost similar to that of an infant)
• Twitching
• Restlessness
• Slurring of speech
• Drooling
• Rapid blinking of the eyes
• Swaying of the hip or waist
• Difficulty breathing

Dyskinesia must not be confused with tremors in Parkinson’s disease. While tremors are a symptom of Parkinson’s, dyskinesia is a side effect of long-term use of levodopa that appears much later.

Treatment options for dyskinesia
Since dyskinesia is often a symptom of another condition, such as Parkinson’s or a brain injury, doctors usually aim at treating the underlying cause. In severe cases where involuntary movements increase significantly, doctors recommend the following:

Relook at levodopa
Changing the dosage of levodopa can help manage dyskinesia. The dose is planned in a way that patients get just enough levodopa to manage or control the symptoms of Parkinson’s and not exceed a limit that will trigger dyskinesia. Many people, more specifically younger people with Parkinson’s, prefer to avoid levodopa early on and opt for other alternative treatments for Parkinson’s.

Evolutes of levodopa
Specific formulations of levodopa, such as Rytary or Duopa gel infusion therapy, stimulate extended dopamine release. Both are known to reduce the fluctuations of dopamine levels, which, as mentioned, contributes to dyskinesia.

Deep brain stimulation
This is a surgical procedure primarily recommended only for those who have had Parkinson’s for more than four or five years and have benefited from levodopa but are troubled by dyskinesia only when levodopa does not seem to work in time.

Botox®
Botox® injections help if dyskinesia movements are seen in the face, neck, and limb region. The injection calms the muscles, reducing involuntary movement. However, there could be side effects.

Melatonin and estrogen
For tardive dyskinesia, doctors administer melatonin and estrogen hormones to regulate dopamine and protect the cells from potential damage from long-term use of antipsychotics.

Doctors are still researching to understand why and how dyskinesia occurs. Several treatments that target various brain chemicals and pathways are in the clinical testing stage. One such non-invasive treatment is under-the-skin levodopa pumps designed to keep dopamine levels consistent, reducing dyskinesia episodes.