Hello, I am 74 years old and was diagnosed with Parkinson’s in 2005. I had DBS in 2014. Until now, I haven’t had any problems with tremors or stiffness at night or in the morning, but recently I’ve been waking up in the middle of the night because my body starts twitching, and the same thing happens in the morning. It feels like something other than hyperkinesia. Could it be something else, or has my brain stopped producing its own dopamine – assuming that brains affected by Parkinson’s are even capable of doing so?

The condition continues to progress gradually, even with DBS treatment and medication. It is therefore most likely that a dopamine deficiency occurs at night, as that is when the longest time has elapsed since the last dose was taken. You can test whether the symptoms improve with an extra dose during the night of, for example, fast-acting Madopark Quick (Mite) a couple of times to confirm that the symptoms are due to a dopamine deficiency. If a pattern emerges, there are many options for adjusting the medication or, possibly, the DBS settings to achieve a longer-lasting anti-Parkinson’s effect at night, which must be assessed on an individual basis. /Håkan Widner