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.
  • Monopolar surgical diathermy should not be used but bipolar diathermy is safe
  • MRI scans in the presence of an implanted DBS should be avoided - seek neurosurgical advice if necessary

For Clinicians

Parkinson's Disease

Criteria for urgent review

  • Unsafe swallow
  • Acute delirium with hallucinations
  • Severe dyskinesia
  • Complex PD medication regime
    • On Apomorphine or Duodopa infusion
    • More than 2 classes of PD drug and / or > 5 doses a day
  • Patients using a deep brain stimulator - DIATHERMY and MRI CAUTION

In these circumstances, please 'pink slip' the team in the normal way, backed up if very urgent with a phone call to the Neurology or OPU secretary. Telephone OPU on ext 1028 or Neurology on ext 4526 or ext 5447

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