Managing Tremors and Dyskinesia in Parkinson’s Disease

Tremors and dyskinesia are distinct movement disorders associated with Parkinson’s disease that require different clinical approaches. While tremors in Parkinson’s are sometimes a problem of not quite enough dopamine medication, dyskinesia is usually a problem of too much dopamine medication [levodopa]. Neurologists differentiate these conditions to tailor medication adjustments.

Understanding the Difference Between Tremors and Dyskinesia

Levodopa is most commonly given to control the movement symptoms of Parkinson's, and tremor usually responds to the medication. Conversely, dyskinesia is often a problem of too much dopamine medication [levodopa].

Treatment Strategies for Parkinson’s Movement Symptoms

Levodopa is most commonly given to control the movement symptoms of Parkinson's, and it often effectively suppresses tremors. However, because dyskinesia is associated with too much dopamine medication, physicians may need to modify a patient's regimen.

• Dose Adjustment: Doctors may manage dyskinesias by slightly decreasing the dosage of levodopa.
• Pharmacological Intervention: Clinicians may prescribe amantadine. Formulations such as Gocovri and Osmolex ER are available to treat dyskinesia.

The Role of Patient-Reported Impact

Medical management relies heavily on the patient’s subjective experience. Clinical severity does not always correlate with a patient’s quality of life. Some individuals may experience a very small tremor that bothers them immensely, while others may have quite a substantial tremor and really don’t seem to care about it very much. Similarly, some people don’t notice dyskinesia at all, and 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. Neurologists emphasize that it is important to ask the person what bothers them, as the most objectively severe symptom may not be the one that bothers them the most.

Summary of Treatment Approaches