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Uncontrolled, involuntary twitches in foot. DYSKINESIA?

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A few months ago, the toes on my right foot started to turn under when I walked. It seemed to just start out of nowhere. Over the past few months, this has prorgressed to walking on the outer edge of my right foot with my toes curled in. It is only my right foot that is affected, my left foot is perfectly normal. Then a couple of months ago the toes on my right foot started to twitch up and down in an uncontrolled and involuntary manner, especially when I am standing.

I am unable to walk normally with my right foot even if I try very hard. I can control it somewhat so that I'm not walking on the outside edge of my foot so much but it's still not how my foot normally lands and pushes off, and the outside muscles of my lower right leg ache very badly after just a short walk. I also seem to have started to "kick off" very slightly with my right foot when I'm walking, and the movement seems to me to be vaguely spastic. When I go down the stairs, the front of my right foot seems to move in a small circle from outside in while it is in the air moving from one step to down to the next.

I am not able to stand with my right foot flat on the ground, even if I try very hard. And all the toes on my right foot show a definite kink, compared to my left foot.

My foot doesn't seem to twitch when I am trying to fall asleep or when I'm asleep, so it is not interfering with my sleep.

I have been on Lexapro (30mg) and Wellbutrin (300mg) for some years now, for OCD. My OCD is well under control and has almost disappeared. For the past year so, I've also been on Thyrozol (10mg) for hyperthyroidism. I take a lot of store-bought paracetemol due to frequent headaches.

My psychiatrist thinks I might have dyskinesia and recently suggested that I see a movement-disorder specialist neurologist, but I haven't done so yet.

I hope one of your specialist doctors will be able to help me. Thank you.

Regards,
Anna


Category: Neurologist, Medical

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Category: Pediatric Neurologist
Dr. Sudhir Kumar is online now

Expert:  Dr. Sudhir Kumar replied 4 Days.

Hello,
Thank you for posting your query at DoctorSpring.com
I have noted your symptoms and agree with your psychiatrist that it is a form of dyskinesia or dystonia. Dystonia is an abnormal involuntary movement disorder, where they may be pain along with abnormal postures/movements.
Evaluation needs to be done to determine the cause. Medications used for psychiatric illness could also be a cause. In addition, MRI of brain and spine should be done.
A trial of levodopa tablets should be given to see if the problem in foot improves.
Other medications that could help are trihexiphenidyl and clonazepam tablets.
In some cases, botox injections are also helpful.
Best wishes,
Feel free to discuss further,
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist


Dr. Sudhir Kumar
Category: Pediatric Neurologist
Experience: 
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
Dr. Sudhir Kumar and 4 other Medical Specialists are ready to help you

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