What are Motor Fluctuations In Parkinson’s Disease?

Motor fluctuations refer to variations in the movement or control of motor symptoms related to intake of Levodopa and dopamine agonists in some of the cases. These fluctuations become highly prevalent among young-onset Parkinson’s disease patients, but few individuals may experience this problem at older age as well.

Gradual loss in the cells responsible for the production of dopamine is the prime factor that results in development of movement problems or motor fluctuations in Parkinson’s disease patients. This indicates that the dopamine level in human brain is dependent solely on Levodopa’s presence in one’s blood, which further relies on your latest medicine dosage.

Motor fluctuations mostly take place after few years of the usage of Levodopa. Many people dealing with parkinson’s disease problem experience movement issues after they complete 5 to 10 years of the treatment. However, if you already start with the intake of dopamine agonists or avoid intake of any medicine for many years even after onset of symptoms, you require only a few weeks or months to appear motor fluctuations.

People developing the problem of parkinson’s disease before 40 years age remain at relatively higher risk to develop dyskinesia and motor fluctuations. Other symptoms however do not have any relationship with body movements. These include fatigue, increase in anxiety, mood changes, difficulty in thinking, sweating and restlessness.

Types of Motor Fluctuations in Parkinson’s Disease

Motor fluctuations or movement problems commonly take place in Parkinson’s disease patients in the form of complications associated with long-term usage of Levodopa. Most of the individuals’ intake Levodopa develops motor problems within only 5 years to 10 years. The main types of motor fluctuations dealt with parkinson’s disease patients include the following-

Wearing Off Effect

Wearing-off periods take place whenever the effects associated with a single dosage of Levodopa fails to last for long time, as expected to last in patients. This results in the decrease of motor symptoms control whenever there is wear off the medicinal effects and symptoms fail to improve until and unless patients take next Levodopa dose. Neurologists may predict these movement problems or motor fluctuations easily according to the timing of each medicine dosage.

Dyskinesia Movements

Dyskinesia movements are uncontrollable, sudden, writhing or jerky movements in Parkinson’s disease patients. These problems may affect the neck, head, legs, arms and other parts of a human body. This problem is particularly common in people of young age dealing with Parkinson’s disease.


Reduction in the levels of dopamine forces human brain to send irregular signals into the muscles. This results in dystonia, whereby, opposing muscles cause simultaneous contract and repetition for a prolonged period resulting in abnormal and painful postures, involuntary twists and difficulties in controlling body movements. This may affect a specific part or the entire body and even last for a few hours or for more than a day.

On and Off Response Periods

On and off response periods in parkinson’s disease patients’ take place without any warning because of fluctuations in the human brain’s dopamine levels. Here, you will find more or less similar symptoms with motor problems taking place because of wearing-off effect. However, doctors often face difficulty in prediction of these problems and in their treatments. Off period takes place suddenly for a few seconds or few minutes and then, parkinson’s disease patients become freeze, while on periods involve uncontrollable movements.

Delay On

A few parkinson’s disease people experience delay in effects after they intake the medicine. This results in noticeable and controlled release of the Levodopa medicine. This is because; it requires time in dissolving into the stomach before the absorption of Levodopa within the blood stream and relayed into human brain.


Freezing refers to a temporary and an uncontrolled inability of a person to move and it lasts for many minutes. This takes place suddenly when a person walks and when his feet stuck towards the ground. This problem may even affect writing, speech, closing and opening of human eyes. Freezing tends to be frequent with the progression of Parkinson’s disease.

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:January 4, 2018

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