Dyskinesia (involuntary movements)

Dyskinesia is the medical term to describe involuntary and uncontrollable movements affecting the whole or part of the body. They can occur without the person noticing, and affect everyone differently – from being mild and infrequent to significantly disrupting your daily activities.

These movements are most commonly considered a side effect of certain medications, rather than a symptom of Parkinson’s itself. However, many ongoing discussions in the scientific community have also defended it as an effect of the natural progression of the disease treated with levodopa therapy.

On this page you can find information about the symptoms of dyskinesia in Parkinson’s, treatments, and how to provide relief at home.

Signs and symptoms: what is dyskinesia in Parkinson’s?

The signs and symptoms of dyskinesia are unintended, involuntary and uncontrollable movements such as:

• twitches
• jerking
• twisting
• restlessness

Dyskinesia can affect different parts of the body, but the most common areas in Parkinson’s are the limbs and trunk.

Dyskinesia affects each person differently both in its timing, frequency and severity. It can interfere considerably with activities or it may be mild and barely noticeable.

Similarly, dyskinesia can affect you for a large part of the day, or it may occur only just before or just after you take medication.

Dyskinesia should not be confused with other symptoms like dystonia or tics. Therefore a clear assessment by a neurologist that can help you recognise these movements is critical.

Is dyskinesia always linked to Parkinson’s disease?

Dyskinesia commonly occurs in Parkinson’s as a probable motor complication of taking the medication levodopa. But it also occurs in several medical conditions including Huntington’s disease. It can also be a side effect of certain dopamine-blocking medications (known as tardive dyskinesia).

Types of dyskinesia

Peak-dose and diphasic dyskinesia

In Parkinson’s, dyskinesia usually occurs when levodopa and dopamine levels in the brain are at their highest. This is known as ‘peak dose’. Dyskinesia that occurs when levodopa is just starting to take effect or is wearing off  (diphasic dyskinesia) is less common.

Other less common types of dyskinesia:

• Tardive dyskinesia (where your face and/or body make sudden, irregular movements you can’t control) develops as a side effect of certain medications. It is most often a side effect of antipsychotic drugs.
• Primary ciliary dyskinesia is a rare inherited genetic disorder affecting the tiny microscopic moving structures lining the airways, ears, sinuses and some other areas of the body known as cilia.
• Biliary dyskinesia, affecting your gallbladder
• Paroxysmal dyskinesia, where a person experiences episodes of involuntary movements. It may be inherited, or due to secondary causes including multiple sclerosis, cerebral palsy, and physical trauma.

Is dyskinesia the same as tremor?

No. Tremor, another common Parkinson’s symptom, shares similar features of involuntary movements but the amplitude, repetitively, locations and rhythm are different from dyskinesia.

Both symptoms are uncontrollable movements. But tremor is a symptom of Parkinson’s, while dyskinesia is considered a motor complication in Parkinson’s. As well as having different causes, they also produce different types of movement.

Tremor:

• a symptom of Parkinson’s
• typical small rhythmic in movement
• when you move a limb, the tremor usually lessens or stops

Dyskinesia:

• typically develops after some years of taking Parkinson’s medication, although some people may develop it earlier (especially if they’re on a high dose of levodopa)
• movements are more unsteady, unpredictable and disorganised
• when you are stressed or fatigued, the movements will normally increase.

How is dyskinesia different from dystonia?

Dystonia is a different condition which causes sustained involuntary muscle contractions and spasms.

Generally speaking, in dyskinesia movements are rapid and dance-like.

Dystonia is slower, painful and twisting, forcing the body into unnatural postures. There are, of course, areas where dyskinesia and dystonia overlap, and it is possible to experience them at the same time.

How is dyskinesia diagnosed and tested?

Dyskinesia is a self reported problem, either reported by the person with Parkinson’s or most commonly by the family or friends that start observing a foot movement, trunk movements or arm movements particularly when the person is fatigued, stressed or with sleep deprivation.

Your doctor will then assess its frequency and impact on daily life and social interactions, and adjust the medication. They might reduce the dosage while trying to maintain best functioning possible.

How common is dyskinesia?

As dyskinesia is believed to be triggered by long term use of the Parkinson’s medication levodopa, it tends to be more common as Parkinson’s progresses.

About 40–50% of people develop dyskinesias after five years of levodopa treatment, according to a review article into levodopa-induced dyskinesias, while the majority of patients will have developed it after 10 years of treatment.

What causes dyskinesia?

The exact cause of dyskinesia is uncertain, but most agree that it is related to the long-term use of certain medications like levodopa, including how your body absorbs these medications over time.

It is thought that an increased sensitivity to dopamine in the brain (as a result of levodopa), combined with the natural progression of Parkinson’s, gives rise to dyskinesia.

When levodopa reaches its peak of effectiveness, and dopamine levels are at their highest, ‘peak-dose dyskinesia’ can occur.

Conversely, and less commonly, dyskinesia can also occur when levodopa is just starting to take effect or when it is wearing off. This is known as ‘diphasic dyskinesia’.

What treatments can help with dyskinesia in Parkinson’s?

Medication

Dyskinesia is treated through medication management. This can however be challenging

As dyskinesia seems to be a side effect of taking levodopa, it might seem logical to reduce the amount taken, or avoid it for as long as possible. However, a reduced amount of levodopa can result in ‘off’ periods (when symptoms are not controlled) which come on more quickly and last longer. This may mean other symptoms, such as tremor, rigidity and slow movement, are less well controlled.

It is therefore important to achieve a good balance between improved mobility and dyskinesia. Each person will need to decide on the balance they prefer: having more ‘on’ time when most symptoms are controlled but dyskinesia is experienced, or more ‘off’ time when dyskinesia is controlled but other symptoms (such as rigidity) re-appear.

If you experience dyskinesia you should talk with your doctor, or Parkinson’s nurse specialist if you have one. They will probably adjust your medication, sometimes trying several combinations, to see if this eases your dyskinesia. If they are not a movement disorder doctor, they may also refer you to a doctor or neurologist who specialises in movement disorders.

Deep Brain Stimulation and other surgical options

If medication does not help and dyskinesia is affecting your quality of life, then surgery such as Deep Brain Stimulation (DBS) may be suggested. However this is not suitable for everyone, and must be discussed with a Parkinson’s specialist doctor.

Other surgical options like pump therapy (duodopa, produodopa, etc) or others (e.g. focused ultrasound) can also be considered. Their primary aim is to reduce on-off phenomena and in doing so can also reduce dyskinesia.

Keeping a motor symptom diary

It is very helpful for your doctor if you keep a motor symptom diary, in which you record the timing, duration and frequency of your ON OFF times and dyskinesia. You and your doctor can then study the link between your dyskinesia and medications. This also helps to assess how effective your medications are and the effects of any adjustments your doctor makes.

Helpful details to record include:

• the times of day when you take your Parkinson’s medication
• the times of day when you have good symptom control
• when your dyskinesia emerges in relation to when you take your medication
• times your dyskinesia is bothersome and times where it is not bothersome

It can also be useful to note the timing of meals, drinks and snacks. Make a note of whether eating certain foods affects your symptom control – protein, for example, can interfere with the absorption of some medications.

What can I do at home to ease dyskinesia?

While medication adjustments are the main way to manage dyskinesia, there are many things you can try to make it less disruptive. None of these will switch the movements off, but they can reduce how often they flare and how much they get in your way.

Manage time of activities

Try to time your day around your good periods. Dyskinesia often comes and goes with your medication cycle. Where you can, plan the things that matter, cooking, outings, exercise, activities that need steady hands, for the times you feel most comfortable, rather than pushing through when movements are at their most bothersome.

Exercise, but adapt

Staying active is good for you, so don’t let dyskinesia stop you. You may find it helpful to plan your exercise around the times when mobility is good and you do not experience extremely troublesome dyskinesia. If you are exercising with dyskinesia, guarantee that the type of exercise doesn’t place you at risk. Modifying the modality of the exercise might be necessary.

A physiotherapist who knows Parkinson’s can help you find exercises that work with your symptoms rather than against them.

Changing position and resting periods

If you have troublesome dyskinesia, try finding resting periods during most impactful moments. If you have severe dyskinesia throughout your body, lying in bed on one side and breathing gently for a few minutes may help. Try not to fight against the movement – it is better to try to relax in a comfortable position.

Managing stress or triggers

Stress, emotional excitement, fatigue, sleep deprivation, and changes in routine or environment can all increase dyskinesia in some people with Parkinson’s. These factors may heighten arousal, alter movement control, and make the nervous system less able to regulate involuntary movements. While managing these triggers will not remove dyskinesia directly, it can help reduce how often it appears, how intense it feels, or how disruptive it becomes.

Practical approaches include planning rest periods, protecting sleep, avoiding excessive fatigue, using calming breathing strategies, and keeping routines as predictable as possible when dyskinesia is a problem.

Because stress feeds dyskinesia, anything that genuinely relaxes you is worth trying. Many people find gentle, mindful activities and complementary therapies like yoga, Tai Chi or massage helpful. These are not a treatment for the movements themselves, but a way to lower the overall tension that can make them worse.

References and acknowledgements

We would like to thank the following:

• Parkinson’s UK for permission to use the following source: Dyskinesia (involuntary movements) and wearing off
• The Michael J Fox Foundation for permission to use the following source: Dyskinesia in Parkinson’s Disease
• Physiotherapist Parkinson’s Specialist (Egas Moniz School of Health & Science, Lisbon) Prof Josefa Domingos for reviewing this information

Content last reviewed: July 2026