Went to Gp yesterday to get a copy of her letter to local hospital re. my next neurology appt as they had discontinued me. No symptoms mentioned in it at all. So I am attempting to summarize my current symptoms for her & whoever I see at the hospital. Below dyskinesias. Using framework from Abnormal Involuntary Movement Scale (AIMS) Munetz & Benjamin (1988). Also done current PD NMS list – piece of cake. Haven’t started on PD motor symptoms …
1.Muscles of facial expression
Blepharospasm - can’t keep eyes open to read to cross road to cycle to watch tv.
Frequent grimacing
2.Lip movements: Constant motion. Chew gum ad nauseum. Falls out if I try to talk
3.Jaw movements :Constantly chewing
4.Tongue movements :Always moving gum in mouth
5.Upper extremities (arms, wrists, hands, fingers)
Right arm inversion – writhing/turning inwards. Doing it a lot when arm on desk
Always trying to keep fingers busy tapping fingers if have to sit on public transport or when pushing walker to try & keep arms on hand grip of walker. To reduce stiffness & jerky arm movements. Sitting watching tv have to crochet or knit constantly.
6.Lower extremities :Legs feet in constant motion sitting/standing. Wear slippers out at desk.
7.Neck, shoulder, hip movements
Neck bad these days. Head tremor & retrocolis aggravating stiffness/soreness. Using neck heatpad a lot. Also torticolis wants to turn to right.
Several years now head bending down esp when walking (?chin tuck). Front neck been BIT TENDER.
Constant squirming hips/trunk when sitting
8.Global severity of abnormal movements
In constant motion (Akathisia). Severity & distress varies according to stress/fatigue
-
Incapacitation due to abnormal movements v. disabling & exhausting. Always eating to maintain weight 9st.
-
Patients awareness of abnormal movements - Very
-
Current problems with teeth or denture
Only 1 tooth left after 17 years severe bruxism. Dentist made me hinged denture to stop them falling out -
Does patient usually wear dentures?
Occasionally when I go out. Get fed up nipping soft tissue. Sore gums after wearing them a couple of daYS IN A ROW.
Task Force Report on Scales to Assess Dyskinesia in Parkinson’s Disease: Critique and Recommendations Carlo Colosimo et al, Movement Disorders Vol. 25, No. 9, 2010,
Drug-induced dyskinesia is common in Parkinson’s disease (PD) and is often associated with social and physical disabilities… The AIMS is a clinician-rated instrument to assess the severity of abnormal movements in different parts of the body… The administration of the scale is short [5-10 mins] and repetitive scores can be easily obtained.
http://www.cqaimh.org/pdf/tool_aims.pdf Abnormal Involuntary Movements Scale - Overview