Twitching and speech impairment query

My husband has had parkinsons for about 4 years now - he is 73 and has also just been diagnosed with Parkinson Dementia (very early stage)-
I have noticed these past few months that he seems to be having trouble with his speech and when he is talking, he is twitching all the time. Is this normal for whichever stage of Parkinsons it is.
many thanks

Hello there, my first ever post! Could this be a meds side effect? I have been noticing this for a few months in my PWP and she said it’s caused by the meds rather than PD.

About October/November 2001 I took a single tablet of Domperidone an anti-emetic for vomiting due to migraine.
By February 2002 I was beginning to have trouble keeping my eyes open. My GP was writing “stress reaction” on my sick notes, In April he wrote to an eye clinic describing “repetitive blinking”. Then in May HE prescribed Sertraline. I took it for 13 days . I went baCK TO him after reading the small print on the Patient information Leaflet. It said, “A side effect of uncontrollable twitching is more likely if the patient is already experiencing symptoms.” . Told him now I can’t sleep so he gave me another drug- Amitriptyline - which I took for two days only. Then the muscles spasms began to spread on my face. The gp wrote to a neuroopthalmologist, “ Her eye twitching is symmetrical and almost continuous, and is causing her considerable distress. She walks around with her eyes mainly shut during the day, which has caused her to bump into lampposts and such.” In July 2002 the eye specialist diagnosed blepharospasm – a focal dystonia.

By October 2002, the first neurology report noted : “Her movements interfere with her speech… there were intermittent eye twitches and spasms, dystonic movements in her lower face and occasional protrusion of the tongue. Her head would frequently exhibit flexion jerks, while subtle choreo-athetoid movements could be detected in her hands and feet.”

You can look up the side effects of any drug you may have been given to see if it is known to caUSE MOvement disorders . You may find a DEScription of what is happening to your speech if you search on “dysarthria parkinson’s”

Domperidone-induced dystonia: a rare and troublesome complication Om Prakash Dhakal, M.Dhakal, and D.Bhandari BMJ Case Rep. 2014; 2014: bcr2013200282

On the fourth day of starting this treatment… his parents noticed that the child’s spech was slurred and he was making strange movements of his lips and tongue.
Extrapyramidal side effects such as dystonias, parkinsonism, akathisia and tardive dyskinesia which are side effects of dopamine antagonists, usually antipsychotic drugs, are very rare side effects of domperidone

The diagnosis of drug-induced dystonia is usually clinical and is made on the basis of history of intake of a drug known to cause this extrapyramidal symptom. So awareness of even rare side effects of a drug is important to make this diagnosis. Proper physical examination with good medical history especially of a drug or drugs taken by the patient in the near past and any history of similar side effects to drugs is essential. A negative family history of similar symptoms is also helpful to exclude primary dystonia. To establish the causal relationship between domperidone and dystonia we applied the Naranjo algorithm …

SINEMET 12.5mg/50mg Tablets Last updated on emc: 18 May 2021
Nervous system: loss of control over the voluntary movements of everyday life, muscle twitching

Sinemet Organon Pharma (UK) Limited Last updated on emc: 12 May 2021
This information is intended for use by health professionals: 4.8 Undesirable effects
The most common are dyskinesias including choreiform, dystonic and other involuntary movements and nausea. Muscle twitching and blepharospasm may be taken as early signs to consider dosage reduction.
Chapter 12 Drug-Induced Movement Disorders J.Wojcieszek (Iatrogenic Neurology J. Biller, Butterworth-Heinemann 1998)

Once symptomatic treatment with levodopa is initiated, patients often develop a variety of new abnormal movements (dyskinesias) that were not present in the untreated condition, such as choreoathetosis, dystonia, stereotyped movements, myoclonus, or akathisia. Nearly one-half of PD patients develop dyskinesias after 5 years of levodopa treatment.
Of the various levodopa-induced dyskinesias, chorea is the most common, often beginning as subtle truncal rocking, head nodding, facial grimacing. or worm-like movements of the hand or foot.

Wow - Appletree - a very interesting explanation - thank you - I will now go and check ALL of his meds especially the small print.