Abstract
Diphasic dyskinesia (DD) is a complex pattern of levodopa (LD) dyskinesia in patients with Parkinson’s disease (PD) in which involuntary movements occur during both peak and trough LD effects. End of dose dyskinesia is usually more severe and often differs in appearance from peak-dose dyskinesia. It commonly causes ballistic flexion-extension, kicking, or bicycling leg movements which often force the patient into a reclining position. There may be associated dystonic postures, mental distress, and autonomic manifestations. DD often occurs toward the end of the day and may sometimes occur only once daily following the final dose of LD when it has been called “evening dyskinesia.”
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References
Apetauerova D, Ryan R, Ro SI, et al. End of day dyskinesia in advanced Parkinson’s disease can be eliminated by bilateral STN or GPi deep brain stimulation. Mov Disord. 2006;21:1277–9.
Zimmerman TR, Sage JL, Lang AE, Mark MH. Severe evening dyskinesias in advanced Parkinson’s disease: clinical description, relation to plasma levodopa, and treatment. Mov Disord. 1994;9:173–7.
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PD-Diphasic dyskinesia.mp4 (MP4 16,904KB)
The patient is reclining on a couch with continuous jerky dystonic posturing in her upper limbs and trunk and repetitive kicking movements of the right leg.
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Bhidayasiri, R., Tarsy, D. (2012). Parkinson’s Disease: Diphasic Dyskinesia. In: Movement Disorders: A Video Atlas. Current Clinical Neurology. Humana, Totowa, NJ. https://doi.org/10.1007/978-1-60327-426-5_6
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DOI: https://doi.org/10.1007/978-1-60327-426-5_6
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Publisher Name: Humana, Totowa, NJ
Print ISBN: 978-1-60327-425-8
Online ISBN: 978-1-60327-426-5
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