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^^^^^^WARM GREETINGS FROM^^^^^^^^^^ Ivan Suzman 48/10 [log in to unmask] Portland, Maine land of lighthouses deg. F *********************************************************** On Sat, 7 Feb 1998 23:53:38 +0100 Ida & Andre Kamphuis <[log in to unmask]> writes: >At 18:40 6-2-98 -0600, you wrote: Dear Ida, I found your observations on diphasic dyskinesia VERY interesting. You wrote about the muscle tension associated with peak dose dyskinesia, but its absence in the second form of dyskinesia, associated with the latter part of a dose. I experience a kind of "rubberiness" at peak- or over- dose, where my neck is impelled to sway in soft, undulating, almost rhythmic oscillation. This "rhythm " feels externally controlled, almost as if I were a marionette. The more dystonic dyskinesia that you associate with peak-dose states, I have seen so many times, especially in what seem like over-medicated states, in other PWP's. I have seen a jerky, "flailing" of the arms, accompanied by great rigidity, in many PWP's, but I myself NEVER experience this peak-dose stiffness,nor any movements associated with weird, abnormal muscle positions. To these two forms of excess motion, I would add a third type, and I wonder, do you or Dennis or David ever note this in yourselves or others? It is a STRICTLY end-of-dose phenomenon. There is very rapid and forceful tremor of the arms. It can occur to me while sitting in a chair, while rising from a seated position, or while trying to walk. It is associated with back-of-the-neck sweating, and leaves me extremely immobilized, and precedes a deeper-than-usual off state, with very tense forearm muscles and great arm pain. It's as if I have depleted my reserves of dopamine, and maybe something else. I almost wonder if TWO chemicals are depleted, i.e., dopamine, which might in insufficient supply cause some sort of muscle tightness, or rigidity, and a chemical "x", which would allow smooth, rather than "cogwheeling" voluntary movement. Is "x" adrenaline?? This rapid end-of-dose arm shaking is so bad that for at least ten minutes, I can barely move my arms from the shoulders down, and meanwhile, I start pouring with perspiration. It's not really surprising that so many neurologists say to us PWP's that we seem to know more than they do. We experience symptoms of dose, overdose and end of dose that they rarely would see, unless they would be willing to spend hours watching us. Ivan Suzman