DYSKINESIA: CLINICAL PICTURE AND RISK FACTORS

Definition of dyskinesia

Dyskinesia is the title of the chapter on kinetic alterations: in the introductory treatment we explored the different types of possible dyskinesias and the triggering causes of 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 the onset of the same.

Symptoms

It is necessary to distinguish two types of movements: hyperkinesias (excessive movements, defined as abnormal, of an involuntary type, accompanied by stereotyped spasms) and hypokinesias (characterized by muscle tension and rigidity, whose motor activity is considerably slowed down).
Involuntary dyskinetic movements particularly involve the tongue, mouth and face; however, the trunk, hands and feet are not always excluded.
Generally, external kinetic manifestations - unlike internal dyskinesias - do not cause intense physical pain; it should not be forgotten, however, that these can create psycho-social disturbances, therefore in some cases dyskinesias can become embarrassing and mentally incapacitating 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 pharmacological treatments) are further cataloged, according to the anatomical areas involved. Among the facial movements and ocular, tics, grimaces and the arching of the eyebrows represent the most common dyskinesias; torsion of the tongue, chewing movements - including bruxism - displacement of the jaw etc. instead characterize perioral dyskinesias.
Furthermore, in the clinical profile of the affected patient, any possible movements of the extremities (torsion of the hands, feet, movements of the lower or upper limbs, lock of the hands, etc.) and dyskinesias affecting the trunk (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 stated, it seems that, without distinction, all the aforementioned old generation medicinal specialties have the same dyskinetic side effects, and that only atypical antipsychotic drugs, at the same dosage, involve less damage to the patient's kinetics. However, it is understandable that if the patient, due to pathological necessities, were to take a higher dosage 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 dosage and duration of treatment.
However, drugs used in the treatment of depression, nausea and dyspepsia have also been shown to be directly related to the manifestation of dyskinesias.
Additional risk factors have been identified, indirectly connected to dyskinesias and mainly related to the patient's age, sex, state of health and habits.
The risk of developing dyskinesias increases as the patient ages; 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 drugs are additional risk factors for dyskinesias. In some cases, a certain predisposition has been found genetics to kinetic disorder.

For some authors, the side effects generated by neuroleptic substances are defined disturbing, as they are potentially responsible for the stigma of psychological disorders: in this regard, the periodic check-up of the doctor is essential.