Definition of dyskinesia
Dyskinesia is the headline of kinetic alterations: in the introductory treatment we have studied the different types of dyskinesias and the causes that trigger motility disorders. In this short article we will analyze the general clinical picture, therefore the altered kinetic manifestations induced by dyskinesias, and the possible risk factors for their onset.
Analysis of the term
Symptoms
It is necessary to distinguish two types of movements: hyperkinesis (excessive movements, defined as abnormal, involuntary type, accompanied by stereotyped spasms) and hypokinesias (characterized by muscle tension and rigidity, whose motor activity is considerably slowed).
Involuntary dyskinetic movements particularly involve the tongue, mouth and face; however, the trunk, hands and feet are not always excluded.
In general, external kinetic manifestations - unlike internal dyskinesias - do not cause intense physical pain; not to forget, however, that these can create psycho-social problems, so in some cases dyskinesias can become embarrassing and mentally invalidating phenomena. In cases of severity, dyskinetic movements could create verbal and swallowing disorders, even hindering chewing.
The clinical picture derived from dyskinesia must be scrupulous and unequivocal: in this regard, the clinical symptoms, typical of tardive dyskinesias (kinetic alterations caused by chronic neuroleptic drug treatments) are further cataloged, depending on the anatomical areas involved. Among the facial and ocular movements, tics, grimaces and eyebrow arching represent the most common dyskinesias; the torsion of the tongue, the masticatory movements - including bruxism - the displacement of the jaw, etc. instead they characterize perioral dyskinesias .
Still, in the clinical profile of the affected patient, possible possible movements of the extremities (torsion of the hands, feet, movements of the lower or upper limbs, lock of the hands, etc.) and dyskinesias of the trunk (the swaying, fluctuations and torsions of the trunk, accompanied by pelvic thrusts). [Taken from: www.discinesia.it]
Risk factors
The risk factor most implicated in the clinical manifestation of tardive dyskinesia is the constant and chronic administration of neuroleptic-antipsychotic drugs; despite what has been said, it seems that, without distinction, all the aforementioned old-generation medicinal specialties carry the same dyskinetic side effects, and that only atypical antipsychotic drugs, with the same dosage, involve less damage to the patient's kinetics. It is understandable, however, that if the patient, due to pathological needs, were to take a higher dose of atypical neuroleptics, dyskinetic movements would still be inevitable.
In other words, considering the category of antipsychotics-neuroleptics, the risk of causing dyskinesia is directly proportional to the increase in posology and duration of treatment.
However, it has also been shown that the drugs used in the treatment of depression, nausea and dyspepsia are directly related to the manifestation of dyskinesias.
Additional risk factors have been identified, indirectly related to dyskinesias and related mainly to the patient's age, sex, health status and habits.
The risk of manifesting dyskinesia increases with advancing age of the patient; it is estimated that women are more at risk of dyskinetic forms than men, particularly during the menopausal period.
Depression, degenerative diseases (eg diabetes) and Parkinson's disease, as well as smoking, alcohol and drug use are additional risk factors for dyskinesias. In some cases, a certain genetic predisposition to kinetic disorder has been found.
For some authors, the side effects generated by the neuroleptic substances are defined as disturbing, since they are potentially responsible for the stigma of psychological disorders: in this regard, the periodic control of the doctor is indispensable.
