Parkinson’s Disease: Diphasic Dyskinesia
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.”
KeywordsDeep Brain Stimulation Mental Distress Involuntary Movement Dystonic Posture Recline Position
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.