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20-September-2008 10:08:30 - Dyskinesia Dyskinesia Classification and external resources ICD-10 G24.9 DiseasesDB 17912 MeSH D020820 Dyskinesia refers to involuntary movements, similar to a tic or chorea. Dyskinesia is a symptom of several medical disorders and is distinguished by the underlying cause. When a dyskinesia presents after treatment with an antipsychotic drug such as haloperidol, it is a tardive dyskinesia and is commonly found in face as tongue rolling. A dyskinesia found in a patient with Parkinson's disease is more commonly a jerky, dance-like movement of the arms or head and usually presents after several years of treatment with medication containing L-dopa. Two other conditions, primary ciliary dyskinesia and biliary dyskinesia, refer to involuntary movements of internal organs. Parkinson's disease In the context of Parkinson's disease, dyskinesias are often the result of chronic levodopa L-dopa therapy. These motor fluctuations occur in more than half of PD patients after 5 to 10 years of levodopa therapy, with the percentage of affected patients increasing over time.1 Dyskinesias most commonly occur at the time of peak L-dopa plasma concentrations and are thus referred to as peak-dose dyskinesias. As patients advance, they may evidence diphasic dyskinesias, which occur when the drug concentration rises or falls. Attempts to moderate dyskinesias by the use of other treatments such as bromocriptine appear to have been unsuccessful. 2 In order to avoid dyskinesia, patients with the young-onset form of the disease YOPD are often hesitant to commence L-dopa therapy until absolutely necessary for fear of suffering severe dyskinesia. Patients with severe dyskinesia resulting from high doses of parkinsonian medication may benefit from deep brain stimulation DBS, which benefits the patient in two ways. Firstly, DBS allows a reduction in L-dopa dosage of 50-60% thus tackling the underlying cause. Secondly, DBS treatment itself in the subthalamic nucleus or globus pallidus can reduce dyskinesias. 3 The use of Methylenedioxymethamphetamine MDMA has been shown to enhance the effects of L-Dopa while reducing the associated dyskinesia in primates with simulated Parkinson's disease.4 See also Hemiballismus akinesia References ^ Obeso JA, et al. The evolution and origin of motor complications in Parkinson's disease. Neurology. 2000;55 suppl 4:S13-S20. ^ van Hilten J, Ramaker C, Stowe R, Ives Nj., 2007. Bromocriptine/levodopa combined versus levodopa alone for early Parkinson's disease. Cochrane Database Syst Rev. 2007 Oct 17;4:CD003634. ^ Hiroki Toda, M.D., Ph.D.; Clement Hamani, M.D., Ph.D.; Andres Lozano, M.D., Ph.D., F.R.C.S.C 2004. Deep Brain Stimulation in the Treatment of Dyskinesia and Dystonia. Neurosurg Focus 171:9-13, 2004. ^ Iravani, M., Jackson, M., Kuoppamäki, M., Smith, L. Jenner, P. 2003. 3,4-Methylenedioxymethamphetamine Ecstasy Inhibits Dyskinesia Expression and Normalizes Motor Activity in 1-Methyl-4-Phenyl-1,2,3,6-Tetrahydropyridine-Treated Primates, Journal of Neuroscience, 23, 9107-9115 v d e Pathology of the nervous system, primarily CNS G00-G47, 320-349 Inflammatory Meningitis Arachnoiditis - Encephalitis - Myelitis - Encephalomyelitis Acute disseminated - Tropical spastic paraparesis - Cavernous sinus thrombosis Systemic atrophies Huntington's disease - Spinocerebellar ataxia Friedreich's ataxia, Ataxia telangiectasia, Herary spastic paraplegia - Spinal muscular atrophy: Werdnig-Hoffman - Kugelberg-Welander - Fazio-Londe - MND ALS, PMA, PBP, PP, PLS Extrapyramidal and movement disorders Parkinson's disease - Neuroleptic malignant syndrome - Postencephalitic parkinsonism - Pantothenate kinase-associated neurodegeneration - Progressive supranuclear palsy - Striatonigral degeneration - Dystonia/Dyskinesia Spasmodic torticollis, Meige's, Blepharospasm - Essential tremor - Myoclonus - Lafora - Chorea Choreoathetosis - Restless legs - Stiff person Other degenerative/ demyelinating diseases dementia: Alzheimer's - Pick's - Dementia with Lewy bodies - Frontotemporal lobar degeneration mitochondrial disease: Leigh's demyelinating: Multiple sclerosis - Devic's - Central pontine myelinolysis - Transverse myelitis - Marchiafava-Bignami disease - CAMFAK syndrome - Alpers' Seizure/epilepsy Focal - Generalised - Status epilepticus - Myoclonic epilepsy Headache Migraine Familial hemiplegic - Cluster - Vascular - Tension Vascular Transient ischemic attack Amaurosis fugax, Transient global amnesia Cerebrovascular disease MCA, ACA, PCA, Foville's, Millard-Gubler, Lateral medullary, Weber's, Lacunar stroke Sleep disorders Insomnia - Hypersomnia - Sleep apnea Obstructive, Ondine's curse - Narcolepsy - Cataplexy - Kleine-Levin - Circadian rhythm sleep - Delayed sleep phase - Advanced sleep phase Intracranial hypertension Hydrocephalus Normal pressure - Idiopathic intracranial hypertension Other encephalopathy Brain herniation - Cerebral edema - Reye's Other spinal cord disease Syringomyelia - Syringobulbia - Morvan's syndrome - Spinal cord compression Retrieved from http://en..org/wiki/Dyskinesia Categories: Neurology | Parkinson's disease Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Español 日本語 Nederlands Polski СрпÑ?ки / Srpski This page was last modified on 27 July 2008, at 04:40
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