How Are Tremors and Dyskinesia Treated?
“We treat these two kinds of movements very differently,” says Herrington. “Dyskinesias are usually a problem of too much dopamine medication [levodopa], and tremors are sometimes a problem of not quite enough.”
It’s therefore important for a neurologist to be able to tell the difference between the two symptoms, he says, and to adjust the medications accordingly.
Herrington points out that not all people are similarly bothered by tremors or dyskinesia. Take tremors, for example. “There are some people who have a very small tremor and it bothers them immensely,” he says. “Other people have quite a substantial tremor and really don’t seem to care about it very much.”
When it comes to treating tremors, doctors may start out by asking people how much the symptom bothers them. “As a physician, you can categorize which symptoms people have or the level of severity,” says Herrington, “but it’s always really important to ask the person what bothers them. The most objectively severe symptom may not be the one that bothers them the most.”
As for dyskinesia, some people don’t notice it at all, he says. “[With dyskinesia] there is often a divergence between how much they notice and are bothered by it and how much their loved ones notice and are bothered by it.”
Levodopa is most commonly given to control the movement symptoms of Parkinson’s, and tremor usually responds to the medication.
Sometimes, doctors manage dyskinesias by slightly decreasing the dosage of levodopa. In addition, another medication, amantadine, is available in two formulations (Gocovri and Osmolex ER) to treat dyskinesia.
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