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Camilla and Peter: I missed most of the postings between 6/25 and 7/15. I have a vague recollection of your description of Peter's new symptoms concerning the involuntary biting of his tongue. I, too have begun to experience lower jaw cramping, biting of the tongue (very painful) and slight shaking of the lower jaw. My self-diagnosis (since I haven't yet reported this to my neuro) is DYSTONIA ["sustained, abnormal, painful, tightening of muscles"] and not Dyskinesias ["abnormal, involuntary movements"]. Since dystonia is attributed to the "wearing-off" of medication (under the umbrella of "Motor Fluctuations") doctors usually prescribe a change in dosage or pattern of dosage, or the addition of an agonist at bedtime. I am going to self-adjust the timing of my third (last) dose of Sinemet CR 50/200 from 4 p.m. to 6 p.m. to see if that helps. [In VOL.18, ISSUE 3, of the Parkinson Report, published by the Nat'l Park. Found., Dr. Juan R. Sanchez-Ramos, M.D., advised a PWP complaining of "...spastic jerking of the lower jaw and biting of the skin inside the lower jaw...", who had tried a mouth guard, that the abnormal movement of the jaw was a "wearing off" symptom and the PWP should try Sinemet CR 50/200 at bedtime.] Since the object of the medication is to increase "on time" and alleviate the symptoms the replacement of Parlodel or Permax with Pramipexole (Mirapex) should relieve the dystonia and increase Peter's "on time." Pramipexole is touted as particularly effective for advanced patients. You mention that Peter does not tolerate dopamine agonists well. For those PWP doctors have been moderately successful with Artane or even muscle relaxants (Flexeril). Good luck. Stephan Schwartz 53/7 <[log in to unmask]>