Involuntary Movements

Abstract Choreiform involuntary movements, “dyskinesia,” are a manifestation of chronic levodopa treatment in Parkinson’s disease. Levodopa-induced chorea presents as brief, irregular, non-rhythmic, flowing, involuntary movements. Risk factors for levodopa- induced dyskinesia include younger age of onset of Parkinson’s disease, greater disease severity, higher levodopa dose, longer duration of levodopa treatment, and female gender. Patients can have varying frequency and severity of dyskinesia. Treatment options for patients with disabling dyskinesia include adjusting the levodopa dose and daily dosing schedule, amantadine, intraduodenal levodopa, and deep brain stimulation. In this chapter, a case of a 69-year-old woman with longstanding Parkinson’s disease on chronic levodopa treatment is discussed, including the disease course, differential diagnosis, workup, and treatment outcome.