Dyskinesia refers to uncontrolled, involuntary muscle movements ranging from shakes, tics and tremors to full-body movements. It can happen with various neurological conditions.

Dyskinesia is a movement disorder that often appears as uncontrolled shakes, tics, or tremors.

Often, the condition occurs in people with Parkinson’s disease due to the overstimulation of their dopamine receptors from medications that increase this neurotransmitter in the brain. One common example of a Parkinson’s medication that can have this effect is levodopa.

Another type of dyskinesia is tardive dyskinesia, which occurs when a person takes certain dopamine receptor-blocking medications. The term “tardive” means delayed, and doctors use the term because this dyskinesia type usually occurs after the long-term use of such medications.

Other possible causes of dyskinesia include

Learn more about dopamine and Parkinson’s disease.

Involuntary movement is the chief symptom of dyskinesia. This can present in only one part of the body, such as a person’s arm or leg, or it can affect the whole body.

Common symptoms include:

  • writhing or wriggling
  • head bobbing
  • fidgeting
  • rocking
  • swaying

However, how exactly the involuntary movements present can depend on the underlying cause. For example, in tardive dyskinesia, the symptoms often present as:

  • rapid blinking
  • waving of the arms or hands
  • sticking out the tongue
  • a random movement of the lips, tongue, or jaw
  • some movements in the limbs, fingers, and toes
  • swaying movements of the hips or torso in severe cases
  • difficulty breathing, also in severe cases

It is possible to classify types of dyskinesia according to the presenting symptoms.

Common types of dyskinesia include:

Parkinson’s dyskinesia

This kind of dyskinesia often presents as uncontrolled, disorganized movements in the legs, arms, trunk, or face. They may be slow or rapid movements and may appear as muscle spasms.

The symptoms can range from mild to severe. They most commonly have links with taking levodopa, a common medication for Parkinson’s disease. However, other medications can also cause dyskinesia, such as certain dopamine agonists and monoamine oxidase-B inhibitors.

An estimated 50% of people aged 40–59 years with Parkinson’s disease receiving treatment with levodopa will develop delayed dyskinesia within 4–5 years. After 70 years of age, the estimate for the condition is 16%.

Tardive dyskinesia

Tardive dyskinesia develops due to a blockage in the brain’s dopamine receptors. It occurs after long-term use of medications such as antipsychotics, antiemetics, and certain antidepressants.

This type of dyskinesia usually presents as uncontrolled movements that primarily affect the face. A person may grimace, stick out their tongue, or make a suction movement with their lips.

Additional factors that increase the risk of developing tardive dyskinesia include:

  • being female
  • being of African American heritage
  • misusing drugs and alcohol

Chorea

Chorea is when a person has brief and irregular contractions or jerky movements that last for a few seconds. This can impact the limbs, head, and face. Symptoms can occur on one side of the body or alternate between both sides randomly.

One of the most common causes of chorea is Huntington’s disease. Another cause is Sydenham chorea, which occurs due to a complication of rheumatic fever in about 20% of children.

Dystonia

Dystonia presents as sustained muscle contractions, often involving repetitive, atypical twisting movements or postures. This can affect different parts of the body.

Some people with dystonia also experience blepharospasms, continuous, involuntary blinking, and writer’s cramp — an inability to write because of an atypical arm or hand posture.

The causes of dystonia are often genetic, but in other cases, doctors do not know why it develops.

Tremors

Tremors are rhythmic movements. Common types of tremor include:

  • Static or resting: When tremors occur in a relaxed, resting, and fully supported limb.
  • Kinetic or action and intention: When tremors occur during the movement of an upper-body part, normally the arm or hand. It usually has links with multiple sclerosis, vascular disease, tumors, and cerebellar degenerative conditions.
  • Postural: This tremor occurs when a person maintains a position against gravity. Postural tremors may present due to physiological factors such as alcohol abuse, antidepressants, and heavy metal poisoning. They may also result from neurological conditions, for example, Wilson’s disease.

Myoclonus

This type of dyskinesia presents as sudden, usually repetitive, muscle spasms and jerks. The causes are often a disturbance in the central nervous system, but nerve injury can also be responsible. Since there are different types of myoclonus, the causes also vary.

Myoclonus types of dyskinesia cause symptoms that are severe enough to be disabling.

Common types of myoclonus include:

  • Progressive myoclonic encephalopathy.
  • Static myoclonic encephalopathy, normally due to oxygen cutoff to the brain.
  • Myoclonic epilepsy, a seizure disorder causing atypical movements on both sides of the body simultaneously.
  • Essential myoclonus, where symptoms usually begin in childhood or adolescence and affect most of the body.

Spasmodic torticollis

Also known as cervical dystonia, this type presents with atypical twisting of the neck and head, usually tipping the head in one direction and rotating the chin the opposite way.

Spasmodic torticollis can develop at any age. Doctors think the cause is genetic, although there may be environmental triggers.

Ballism

Ballism represents wild, often violent throwing or flinging of the arms or legs.

Depending on their severity, these spasms may be powerful enough to cause mild to severe injury and may even cause shoulder, hip, or knee dislocation.

Ballism normally affects multiple limbs and both sides of the body, while hemiballism affects just one side or limb.

The causes of ballism are often cerebrovascular events that include brain injury, asphyxia, which refers to suffocation, or stroke. Other causes include metabolic disorders, exposure to toxins, genetic disorders, or vitamin deficiencies.

Athetosis

This type is slow, turning, bending, or writhing movements, most often in the fingers, toes, and hands. The tongue, arms, legs, and neck can also become affected.

Athetosis usually happens due to brain damage, specifically due to a lack or loss of oxygen or blood supply.

Stereotypies and tics

This dyskinesia type usually occurs as repetitive, useless movements or muscle twitches. An individual may still have some initial level of control over these movements and could even have the ability to reduce them.

Because of this, some medical professionals may not consider stereotypies and tics to be a type of dyskinesia.

Depending on the severity, the symptoms of stereotypies and tics range from mildly irritating to disabling. Types include:

  • Simple tics: Usually involve sudden rapid muscle twitch in the same spot.
  • Common motor stereotypies: Usually involve repetitive and aimless but often ritualized motions.
  • Complex, multiple tics or stereotypies: Usually involve extensive severe tics or twitches. Especially when associated with Tourette’s syndrome, symptoms may include random, inappropriate actions, such as outbursts of swearing.

In some rare cases, complex stereotypies and tics can develop from the use of certain drugs.

In many cases, treating dyskinesia involves addressing the underlying cause. Often, a doctor will not treat the condition unless the person’s symptoms are severe.

If it is severe and the cause is a disorder, infection, or injury to the brain, then doctors will treat them.

If the cause is a certain medication, such as levodopa, the first treatment is to stop using the medication or change the dosage. There are also medications a person can take to control muscle spasms. However, this can be challenging because many of these medications are also known to cause dyskinesia. A doctor will need to determine the best medication according to the type of dyskinesia and the severity of an individual’s symptoms.

Treatment of tardive dyskinesia also includes medications such as tetrabenazine (Xenazine), deutetrabenazine (Austedo), or valbenazine (Ingrezza).

Aside from medications, injections of botulinum toxin or Botox may help reduce or limit involuntary movements, especially those affecting the face.

Additionally, deep brain stimulation is a procedure where doctors place electrodes in the brain to correct movement and control posture. Health experts consider the technique most effective in people with genetic or idiopathic dyskinesia, the latter being where there is no known cause.

With dyskinesia, the outlook largely depends on the cause and the nature of the presenting symptoms.

If the symptoms are mild and the underlying cause is not life threatening, a person could maintain everyday quality of life with the condition.

However, symptoms can worsen gradually over time or develop suddenly or intensify. In those cases, an individual’s condition may become debilitating without treatment.