Spontaneous wriggling or writhing movements which can occur when the medicine is working (i.e. the patient is 'on').
A rhythmic, oscillating movement, most commonly of the hands and or limbs.
When the patient is adequately treated and movements are reasonably fluent and spontaneous.
When when the patient's medication has worn off and movements are slow, deliberate and difficult. Other less visible symptoms of pain and distress may be a feature for some patients.
A noticeable transition from 'on' to 'off' occurring between doses of medication.
An umbrella term for the motor complications of more 'brittle' advanced disease. Patients can fluctuate from 'off', to 'on' and "on with dyskinesia." The change may be gradual or a sudden switch.

For Clinicians

Parkinson's Disease

Care of the Dying in PD

Don't assume a quiet, curled up PD patient is dying – they may just be untreated! Never put a PD patient who is not getting regular, adequate medication onto the Care of the Dying Pathway without specialist input.

A patient's story:
"A woman with Parkinson's disease fell and broke her hip and was admitted into an acute assessment ward. Her medication, including Madopar was stopped.

"She was then judged too ill for any operation, was thought to have had a stroke and could not move, speak, eat, etc.

"The family was told that she was dying and after 10 days she was moved into a general ward.

"Whilst there, the family managed to persuade the staff to restart the Madopar. The woman made a rapid improvement and eventually came home again."
(Parkinson's UK anonymous account from a patient)

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