Originally posted by Shuckins
There have been two films of Michael J. Fox aired recently on the news in relation to his stumping for a Democratic candidate in Missouri who favors stem cell research: The first shows him preparing to testify before Congress, showing hardly a wiggle or tremor from his disease; the second shows him in full campaign mode trembling and jerking violently.
So, which is the real Michael J. Fox? Probably both. In the second film he had quite obviously deliberately neglected to take his medicine for a couple of days to exaggerate the effects of his condition.
No. The abnormal movement (dyskinesia) is caused by the medication. With PD, a group of dopamine-producing cells in the brain die. This causes slow movement, rigidity, and tremor -- think Muhammad Ali. Treatment with drugs that increase dopamine initially help relieve these symptoms.
But with time, as more of the brain cells die, you need a higher and higher dose of medication to control the symptoms. And with higher doses come the side effects -- excess movement. With advanced disease, there is a very narrow dose window between not enough drug -- inability to move and too much drug --excess, abnormal movement.
Fox's abnormal movements are not from stopping his drug, it's from his blood level of the drug peaking too high -- peak dose dyskinesia. Although this appears obviously abnormal to viewers, most patients prefer this to their "off time" when they can hardly move or speak. For Fox to give an interview he has to take enough medication to be able to talk.
When he testified in congress 6 years ago, it was easier to control his signs with drugs. His disease has progressed a lot since then and he will eventually get to the point that drug will be ineffective at controlling the signs. He will become unable to maintain an upright posture, might develop dementia, and will die of some complication, such as pneumonia from inability to swallow normally.
