Tremors and dyskinesias in Parkinson’s disease

Tremor is the most common movement seen in persons with Parkinson’s disease. But other movements can also be seen.

A resting tremor, which is found in about 80 percent of persons with Parkinson’s disease, is a rhythmic movement that most often starts in one hand. It generally is most prominent when the hand is resting and relaxed. Over time it often travels to the opposite hand or to the leg on the same side of the body. Head tremors are not very common in Parkinson’s but a chin tremor can be seen fairly frequently. Parkinson’s tremors are generally treated with the same medications as other symptoms of the disease. A medication called trihexyphenidyl or Artane is used exclusively to treat tremor. It is the most effective medication for tremor, but has to be used with caution as it can cause problems with confusion and make urination difficult.

In addition to tremors, we also see dyskinesias in persons with Parkinson’s disease. Dyskinesias, also known as chorea, are more of a flowing, dance-like movement that is not rhythmic. The term chorea actually comes from the Greek work choreia, meaning dance. Michael J. Fox is a very good example of someone with dyskinesias. These occur generally a bit later in the disease course and are due to a combination of the disease itself and the medications (primarily levodopa) used to treat the disease.

There are a number of ways to treat dyskinesias, including trying to reduce Parkinson’s medications, starting a medication called amantadine and undergoing deep brain stimulation surgery. It is important to be able to distinguish dyskinesias from tremors, as the treatments are often very different.

Amie Peterson, M.D.
Assistant Professor of Neurology
OHSU Parkinson Center of Oregon
OHSU Brain Institute

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Comments

  1. How do you tell the difference between Parkinson Tremor’s and hand shaking from epilepsy?

    Thanks, Liza Castleberry

  2. Great question, Liza. I’ll ask Dr. Peterson and get back to you. -Anne

  3. Liza,

    Dr. Peterson shared that epilepsy generally involves an alteration in consciousness, while Parkinson’s patients are awake and alert when they experience their tremors.

    Hope this is helpful! -Anne

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