A dysfunction sometimes linked to Parkinson’s…
Parkinson’s patients and those around them are often familiar with the medical term “dyskinesia”, less so among the general public. There Miss France 2024, Eve Gilles, lifted the veil on this “invisible illness”, precisely on its “paroxysmal” form from which she has suffered since she was 14. “I felt like I had no control over my body on certain movements, it could be an arm moving inwards, it could be my whole body. It can even be on the face. That’s why often, when I have a crisis, I close my eyes. (…) I don’t want to be seen like this“ she told the Konbini media on October 26.
Definition: what is dyskinesia?
Dyskinesia refers to involuntary, abnormal movements of the body. “These are movements that I do not control for a certain time, between 25 and 40 seconds” shared Eve Gilles in her testimony. There are several types of dyskinesia. “It is a complex pathology because it brings together different forms of choreic and dystonic involuntary movements.” explains Professor Luc Defebvre, neurologist at the Parkinson Expert Center in Lille. A choreic movement is an anarchic movement of swinging or extension-flexion of a limb, neck or trunk while a dystonic movement is a posture abnormality of a part of the body Dyskinesia often occurs in people with neurological disorders, such as Parkinson’s disease, due to an imbalance in the production of dopamine or as a side effect of certain treatments. Movements may be slow. , jerky or uncontrollable.
The paroxysmal dyskinesia from which Eve Gilles suffers is not linked to Parkinson’s disease. It is a specific type of dyskinesia that manifests itself as sudden and temporary episodes or “paroxysms” of abnormal movements. It can be triggered by certain factors such as stress, movement, fatigue or emotional changes. Attacks can last from a few seconds to several minutes, and between episodes the person does not have any particular motor symptoms.
Septal dyskinesia can appear in cardiology when an abnormality in the interventricular septum of the heart is suspected. It can occur after a myocardial infarction or indicate significant pulmonary arterial hypertension.
Ciliary dyskinesia has no link with neurological dyskinesias. This is an abnormality of the beating of the cilia located in the nose and bronchi responsible for protecting the lungs from inhaled bacteria. These respiratory dyskinesias are the cause of chronic ENT pathologies such as rhinitis, rhino sinusitis, repeated acute otitis media, chronic wet cough or even dilation of the bronchi. In 50% of cases, this type of dyskinesia is accompanied by situs inversus, that is to say an inversion of the organs of the thorax and abdomen: this is then called Kartagener syndrome.
What causes dyskinesia?
Dyskinesia mainly occurs after taking treatment to treat psychosis or Parkinson’s disease. It is induced by taking neuroleptics or by taking L-Dopa (Parkinson). According to Professor Defebvre, when taking neuroleptics, two situations are possible: “Acute dyskinesia – a rarer case – which occurs from the first treatment and whose movements are mainly dystonic or a later dyskinesia – more frequent – which occurs after several months or years of treatment and whose movements are mainly dystonic. both choreic and dystonic. In the context of dyskinesia induced by L-Dopa, two patterns are also visible: “Dyskinesia appearing just after taking the treatment or after taking the treatment with dystonic movements affecting the feet or dyskinesia occurring at the peak of the treatment with choreic movements affecting the upper part of the trunk, the neck, the face or limbs.“In the latter case, the attack can last 30 to 45 minutes.
What is Tardive Dyskinesia?
Tardive dyskinesia is quite common. “It comes after several months of neuroleptic treatments. Tardive dyskinesias mainly occur with first generation neuroleptics. The movements can be both choreic and dystonic and are located mainly in the mouth, tongue and face. When dyskinesia is late it is often permanent. underlines Professor Defebvre.
What are the symptoms of dyskinesia?
The main symptoms are uncoordinated, involuntary, repetitive movements, jerky or not, but also continuous muscle spasms which interfere with involuntary movements.
“First of all, dyskinesia is visible, it cannot be hidden. By finding out about their medical file, if the patient has Parkinson’s or psychosis and is treated with L-Dopa or neuroleptics, we quickly understand that his movements are dyskinesia.”
“When dyskinesia is caused by taking neuroleptics, it is possible to reduce or stop the treatment but sometimes, even when stopping, the dyskinesia persists. In this case, we are limited in terms of therapies: we can offer botulinum toxin injections or offer a treatment similar to neuroleptics called Xenazine.“, explains the neurologist. In the event of dyskinesia caused by the treatment of Parkinson’s disease, it is possible to adapt the doses of the treatment or to carry out deep brain stimulation.
Thanks to Professor Luc Defebvre, head of the Neurology and Movement Pathology department at Lille University Hospital and President of the College of Neurology Teachers.