Ervin,

A week ago I would have sworn that for dyskinesia (as it relates to PD) to
occur you would have to be taking levodopa.   Now it seems, from Charlie's
reply, that it can be caused by over-stimulating the STN even in the absence
of levodopa. I'm thinking of changing my signature group to read "Haven't
you heard! It's all been changed".  :))


Dennis


From: Charles T. Meyer, M.D. <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, 12 August 1999 10:46
Subject: Re: what is dyskinesia?/experiments


> Ervin,
>
> It  is unusual to have dyskinesia without meds.  I had it for a while when
my
> stimulator was turned up too high.  Also tardive dyskinesia which can
occur when
> one takes neuroleptics for a long period of time produces-  by a different
> mechanism than levodopa induced dyskinesia- dyskinesia which actually gets
worse
> when the offendinding drug is withdrawn!!
>
> Charlie
>
> ERVIN J MCCARTHY wrote:
>
> > Dennis, is impossible to have dyskinesia  and not be using drugs?
Thanks
> > [log in to unmask]
> > ----- Original Message -----
> > From: Dennis Greene <[log in to unmask]>
> > To: <[log in to unmask]>
> > Sent: Wednesday, August 11, 1999 5:56 PM
> > Subject: Re: what is dyskinesia?/experiments
> >
> > > Tom, Brian, Ida and others,
> > >
> > > Brian wrote:
> > >
> > > > I believe that a pallidotomy,
> > > > effectively turns down the gain of the feedback signal, thus making
a
> > > > better match to the feeble signal from the Parkinsons-affected
brain.
> > > >   Similarly, closing your eyes frees the brain from having to cope
with
> > > > another possibly conflicting signal. Note: If you have had a
Pallidotomy
> > > > the eye-closing routine might have a quite different effect, since
the
> > > > Pallidotomy and the eye-closing may be additive, subtractive, or
simply
> > > > the pallidotomy may swamp the eye-closing effect.
> > >
> > > In my experience mild to medium strength dyskinesias (not to mention
many
> > PD
> > > symptoms per se) can be reduced by a range of comfort giving
activities.
> > > These include emptying the bladder, putting on sunglasses on a bright
day,
> > > taking off uncomfortable footwear, getting out of the heat in summer,
> > > getting into the warmth in winter, adding or removing  clothing as
> > required
> > > by temperature changes. NOTHING, other than waiting it out, helps with
> > > strong dyskinesia.  My speculation as to why this is so runs along the
> > lines
> > > of Brian's 'conflicting signal' comment.
> > >
> > > Since reading Tom's question I have tried a few experiments on myself
and
> > > one other person, with the following results.
> > >
> > > In my own case (and like Ida I have had a pallidotomy) I found that
> > closing
> > > my eyes resulted in a distinct pause in the mild dyskinesia I am
> > > experiencing at present during my short 'on' periods.  However, within
30
> > > seconds the dyskinesia re-established itself and continued on its
merry
> > way.
> > > It is clear that closing the eyes has some effect on dyskinesia but
just
> > > what mechanism is at work is a moot point.
> > >
> > > The results of my experiment with my friend were very interesting.  He
is
> > a
> > > man of +/- 50 years of age who has had PD for over 10 years.  He has
not
> > had
> > > surgery and, not being a member of this list, had no knowledge of this
> > > discussion.  Seeing him experiencing medium level dyskinesia I asked
him
> > to
> > > close his eyes and keep them shut.  This he did - with no discernible
> > change
> > > in his dyskinesia. I then told him about this discussion and of course
he
> > > immediately tried again.  This time, to my amazement, his dyskinetic
level
> > > dropped to mild.  He opened his eyes soon afterwards so I have no idea
how
> > > long the change would have lasted.  I am well aware that the response
of
> > one
> > > subject to one brief experiment is hardly definitive but it does
introduce
> > > the possibility of a placebo effect.
> > >
> > > Dennis
> > >
> > > +++++++++++++++++++++++++++
> > > Dennis Greene 49/dx 37/ onset 32
> > > There's nothing wrong with me that a cure for PD won't fix!
> > > [log in to unmask]
> > > http://members.networx.net.au/~dennisg/
> > > +++++++++++++++++++++++++++
>
> --
>
****************************************************************************
**************
>
> Charles T. Meyer,  M.D.
> Middleton (Madison), Wisconsin
> [log in to unmask]
>
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**************
>