Motor Aspects

Motor Fluctuations in Parkinson's Disease

The term ‘motor fluctuations’ means that after a number of years of levodopa treatment, people may find that the smooth and even control of symptoms that their medicines once gave them is no longer dependable. The most common motor fluctuations experienced in Parkinson’s are “On/ Off”, “Wearing Off”, Dyskinesias and Freezing. For more information read our leaflet: M1.1 Motor Fluctuations in Parkinson's Disease

Dyskinesia in Parkinson's Disease

Some people may experience involuntary, dance like movements in their arms, trunk and legs. These involuntary movements are known as ‘dyskinesias’ and can include twitches, jerks, twisting or writhing movements, or simple restlessness. They occur initially when the level of levodopa in the bloodstream is at its peak, but may appear at any time later on. Dyskinesias are associated with long-term use of levodopa containing medicines (trade names Sinemet, Madopar and Stalevo) and they usually occur in people who have had Parkinson’s disease (PD) for some time. For more information read our leaflet: M1.2 Dyskinesia in Parkinson's Disease

On/Off in Parkinson's Disease

The “On/Off” Phenomenon in Parkinson’s Disease (PD) is related to fluctuating benefit of the medications used to treat PD. Being “On” describes the time when the Person with Parkinson’s (PwP) feels that their medication is beneficial and that their symptoms are well controlled. Being “Off” describes the time when the PwP feels that their medication is not working as well as usual, and some of their symptoms may have returned (either motor: stiffness, slowness or tremor; or non-motor: anxiety, nausea, depression). For more information read our leaflet: M1.3 On/Off in Parkinson's Disease

Wearing Off in Parkinson's Disease

“Wearing Off” is a term used to describe when a person with Parkinson’s disease (PD) feels that the benefit of their levodopa medication has begun to fade away, and do not last until the next dose of medication. The “Wearing Off” phenomenon in PD is associated with long-term use of levodopa containing medicines (trade names Sinemet, Madopar or Stalevo). For more information read our leaflet: M1.4 Wearing Off in Parkinson's Disease

Freezing in Parkinson's Disease

Many people with PD will experience freezing at some point. “Freezing” is used to describe the experience of briefly stopping suddenly while walking or when initiating walking and being unable to move forward. People feel as though their feet are stuck to the ground. It also commonly occurs when trying to turn in small spaces or when walking through doorways. If you have trouble starting a movement or when you try to step forward just after you’ve stood up, this is sometimes called ‘start hesitation’. Freezing can also happen with thought. Some people find this when they are trying hard to remember something in particular, for example trying to remember names. Freezing can be most common in times of stress or anxiety. Sensory cues, such as auditory, visual, or touch triggers, are employed to overcome these “Freezing” episodes. For more information read our leaflet: M1.5 Freezing in Parkinson's Disease

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