health of the nervous system

Dyskinesia in brief: summary of dyskinesia

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Disorder	Dyskinesia: is part of the kinetic disorders. It consists of involuntary-hyperkinetic or hypokinetic- movements of the musculature. Dyskinesia represents an appreciable difficulty in controlling muscle movements.
Etiopathological framework of dyskinesia	Traumatic events, autoimmune diseases, ischemic pathologies of cerebral circulation, CNS infections, disorders of peripheral nerves and degenerative genetic diseases or caused by improper use of drugs
Dyskinesias and DIMD	DIMD: heterogeneous group of movement disorders induced by pharmacological specialties Dystonia: involuntary muscular contractions, protracted over time, characterized by repetitive and rhythmic gestures Akathisia: internal tremor Tardive dyskinesias: collateral dyskinesia typical of the administration of antipsychotic-neuroleptic and anti-emetic substances. Characterized by involuntary hyperkinetic movements, rigidity, muscle tension, bradykinesia, stereotyped, frequent and rhythmic movements Tardive dyskinesia from suspension: hyperkinetic movements result in the interruption of drug therapy
Mechanism of action of antipsychotics	The antipsychotic substances exert an antidopaminergic action: the antipsychotics block the D2 receptor for dopamine (a neurotransmitter also implicated in the brain mechanisms of movement control) causing alteration of muscular movements
General classification of dyskinesia	Atetosis: involuntary movements are particularly slow Korea: movements appear rapid, continuous and uncontrolled Cramps: the movements are involuntary and painful, whose cause lies above all in the excessive muscular effort Dystonia: abnormal posture taken by the body Hemiballism: particularly violent body movements Myoclonus: short involuntary and temporary movements typical of sleep Syncinesia: involuntary movement with a limb, when movement is taking place in the other limb Tic: repeated, identical and rhythmic movements (psychogenic nature) Tremors: rhythmic muscle oscillations not foreseen by the CNS, generated by antagonistic muscle bundles
Dyskinesias and internal anatomical movements	uterine dyskinesia biliary dyskinesia myocardial dyskinesia dyskinesias of the upper esophageal sphincter primary ciliary dyskinesia
Dyskinesia: terminology	Dyskinesia properly speaking refers only to dysfunctions of the extrapyramidal system
Dyskinesia: clinical picture	Type of movements: hyperkinesis hypokinesia Location of dyskinesias: face, tongue, mouth (more frequent), trunk, limbs (less common) Psychological consequences: possible psycho-social disorders, mentally invalidating General clinical picture: Facial and ocular movements Perioral dyskinesias End movements Dyskinesias in the trunk
Dyskinesia: risk factors	Constant and chronic administration of neuroleptic drugs - antipsychotic drugs used in the treatment of depression, nausea and dyspepsia The risk of causing dyskinesia is directly proportional to the increase in the dosage and duration of treatment. Aging of the patient Probably, women are more at risk, particularly during the menopausal period Depression, degenerative diseases (eg diabetes) and Parkinson's disease Smoking, alcohol and drugs Possible genetic predisposition
Dyskinesia: diagnosis	Particularly complex diagnosis due to the variety of dyskinetic forms: Multidisciplinary approach Clinical-objective examination of the patient: control of all hypokinetic or hyperkinetic movements of the patient Psycho-neurological analysis of the patient AIMS scale: investigation tool useful for recognizing the initial symptomatology of dyskinesia and for monitoring any pathological degeneration over time Laboratory tests (eg SMA-18, CBC, etc.) Family history (to test hypothetical neurological diseases)
Dyskinesia: therapies	Reduction of the posology of neuroleptic substances for patients who still have psychotic disorders Drug suspension when the patient has completely recovered from psychosis New possible effective therapeutic options: vitamin D, botulinum toxin and tetrabenazine
Dyskinesia: possible side effects of therapy	Abstinence dyskinesia : the interruption of drug therapy generates an initial and paradoxical strengthening of dyskinesias (reversible condition)
Dyskinesia: prevention	Administration of new-generation atypical neuroleptics Replacement of the neuroleptic drug with another, with less side effects on muscle movement