Dear Listmembers
A Quote from: Watts en Koller: Movement Disorders,
Dystonia is an abnormal movement ,chacterized by sustained muscle
contraction, frequently using twisting and repetitive movements or abnormal
postures.{ }
According to the part of the body that is involved, dystonia is classified as
focal (for example blepharospasm , the inability to open ones eyes, and
torticollis) or segmental or hemidystonia (one half of the body is dytonic)
or generalized dystonia.
End Quote
If the the generalised dystonia is not to heavy, it results in stiffness.
which is a
contraction of all muscles the xxx and xxx , This causes a tired feeling.
Every movement takes more energy. Dystonia tends to increase with stress,
fatigue and emotional upset and to be relieved by sleep and rest.
Stiffness is one of the three main symptoms of Parkinson. The other two are
tremor and disturbances of coordination.
But stiffness also night be a side effect of Sinemet. The instruction
leaflet and the
Merck Manual mention it.In Movement Disorders,the writers have made a
difference between two kinds of
leva dopa produced reactions. The top meds reaction is according to them
not dystonic but only dyskinetic. The reaction on "wearing off" is dystonic
dyskinesia. The book says : Frequently they don't notice or are not
bothered by choreic movements (of the top of meds}even when they are
obvious and distressing for family members In contrast"off period
dyskinesia" can be quite painfull and disabling This has also been my
experience.
The next QUOTE IS FROM THE ALGORIT HM OF MANAGEMENT OF PD
For the dyskinesia pattern to become obvious, the levodopa dose must be
adequate; too
low a dose will simply result in dyskinesias, whereas a higher dose allows
the full
pattern to develop[124] The usual dosages of carbidopa-levodopa used to
treat
conventional parkinsonian motor problems are adequate for demonstration of
the diphasic dyskinesia pattern (ie, 100 to 250 mg of levodopa). Typically,
it is the end-of-dose dyskinetic period rather than the initial dyskinetic
phase that is the more troublesome and sustained. It tends to occur at a
fairly well-defined portion of the levodopa response cycle, usually 2 to 8
hours after a single dose of carbidopa-levodopa. One treatment strategy is
to overlap four to five doses of carbidopa-levodopa at intervals that are
just long enough to preclude the development of the dyskinetic phase at the
end of each dosage cycle[124]
After the last dose, however, patients will cycle through the dyskinetic
phase but at
a relatively predictable time. Thus, they can arrange to be at home-and
perhaps self
administer a mild, short-acting tranquilizer such as alprazolam--during the
time
the dyskinetic period is expected.
Ida
Kind regards / Vriendelijke groeten
Ida Kamphuis
