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KarayanMD
KarayanMD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 840
Experience:  Board Certified Neurologist with Subspecialty in Clinical Neurophysiology. Private Practice.
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I was diagnosed with parkinsons disease in 2012. I have been

Resolved Question:

I was diagnosed with parkinsons disease in 2012. I have been on madopar for over three years and currently on 250mg four times daily. In the last three months I have been having new involuntary head and neck movement. I also have off periods and end of dose deterioration. My walking grinds to a halt and I festinate. Walking has become extremely difficult What do I need to do.My neurologist want to observe but I am very worried. what do I need to do?
Submitted: 1 year ago.
Category: Neurology
Expert:  KarayanMD replied 1 year ago.

Hi. Thanks for your question. I am a board certified neurologist in the U.S. I will be happy to help.

How old are you?

Expert:  KarayanMD replied 1 year ago.

Also, are these head and neck movements tremors, or something different, like a writhing irregular movement?

Customer: replied 1 year ago.
I am 63 years old . The head and neck movement have been described as to and fro movement /dystopia and said to be dyskinesia due to Levi dopa therapy.
Expert:  KarayanMD replied 1 year ago.

OK. Thank you for your reply. One option you can discuss with your neurologist would be to consider adding a medication called Amantadine, if you have not tried this. Amantadine can help with dyskinesias and also with more typical Parkinson's symptoms as well. Another option might be to switch to a long acting form of Parkinson's medication and perhaps lower the dose of the Madopar, to see if that might lessen the dyskinesias, while helping your other Parkinson's symptoms at the same time. In the US, such options include pramipexole and ropinirole in the extended release forms. Another option that you may consider discussing would be deep brain stimulation, which is a surgical option that can be very helpful for many patients with Parkinson's Disease.

Expert:  KarayanMD replied 1 year ago.

Hopefully this has been helpful to you. Please let me know if you have more questions and I will reply as soon as I have time to do so. If this was helpful, please remember to rate me highly. Bonuses always appreciated. Best of luck.

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