Dyskinesias

Dyskinesias include acute dyskinesia from dopamine blockers in Parkinson's, tardive dyskinesia from prolonged anti-dopaminergic use, peak dose dyskinesia in Parkinson's due to Levodopa, spontaneous dyskinesia in the general population, and Meige syndrome (cranial dystonia), treatable with zolpidem. Management varies based on the type and cause.

2024-01-06 17:31:59 - Editor

Dyskinesias are involuntary movements. It can affect just one part of the body, such as, the arm or the head or it can affect the whole body. They include the following:

1-Acute dyskinesia

which occur immediately after introduction of a dopamine receptor blocking agents mostly Levodopa in Parkinson disease. Acute dyskinesia is usually dystonic and manifest as oculogyric crisis, oromandibular dystonia and cervical dystonia. Treatment requires manipulation of the patient's antiparkinsonian drug. It usually resolves within one month of discontinuation of the offending drug. (1, 2)

2-Tardive dyskinesia

Tardive dyskinesia is a hyperkinetic movement disorder which appears after prolonged use of anti-dopaminergic agents, such as, metoclopramide, olanzapine and haloperidol. It has numerous clinical manifestations including chorea, athetosis, dystonia and stereotyped behaviours. (For details, please refer to the heading Tardive dyskinesia). (3, 4)

3- Peak dose dyskinesia

Peak dose dyskinesia in Parkinson disease in which dyskinesia is caused by overstimulation of dopamine receptors. As a peak dose effect; it usually starts 30 to 60 minutes after levodopa dose. Peak dose dyskinesia appears when the patient is "on" and is often choreiform in nature. (For details, please refer to the heading Parkinson disease Peak dose dyskinesia).

4- Spontaneous dyskinesia

Spontaneous dyskinesia; which is mainly orofacial. It occurs in 5% of the general population without any history of exposure to dopamine receptor blocking agents. Also, it may be an early manifestation of schizophrenia. (5, 6)

5-Meige syndrome

Meige syndrome is an idiopathic cranial dystonia with onset in middle aged people. It usually manifests by oromandibular dystonia and blepharospasm. When severe, it could benefit from oral zolpidem 5 mg daily. (7)

References

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