FrancophonIA/ELRC3.0 huggingface dataset:
English: Each pack of 21 prolonged-release tablets for a 3-week treatment schedule contains: 7 tablets of Oprymea 0.26 mg
Danish: Hver pakke med 21 depottabletter til 3 ugers behandling indeholder: 7 tabletter indeholdende Oprymea 0,26 mg
English: - treat the symptoms of moderate to severe primary Restless Legs Syndrome in adults.
Danish: - behandling af voksne patienter med symptomer på moderat til svær restless legs syndrom
English: Other medicines and Oprymea
Danish: Brug af anden medicin sammen med Oprymea
English: The efficacy and tolerability of an overnight switch from pramipexole tablets to pramipexole prolonged-release tablets at the same daily dose were evaluated in a double-blind clinical study in patients with early Parkinson's disease.
Danish: Virkningen og tolerabiliteten hos patienter, som fra dag til dag skiftede behandling fra pramipexol tabletter til pramipexol depottabletter, blev undersøgt i et dobbelblindt klinisk studie hos patienter med tidlig udvikling af Parkinsons sygdom.
English: When the intake of a dose is missed, Oprymea prolonged-release tablets should be taken within 12 hours after the regularly scheduled time.
Danish: Hvis patienten glemmer en dosis, bør Oprymea depottabletter tages indenfor 12 timer fra det sædvanlige tidspunkt.
English: 63 % of patients on pramipexole and 52% of patients on placebo reported at least one adverse drug reaction.
Danish: 63% af patienterne i pramipexolbehandling og 52% af patienterne i placebobehandling rapporterede mindst én bivirkning.
English: After that, your doctor may increase the dosing frequency to one 0.26 mg prolonged-release tablet every day.
Danish: Derefter vil din læge muligvis øge dosis til én 0,26 mg depottablet hver dag.
English: The symptoms include: - akinesia (loss of muscle movement) - rigid muscles - fever - unstable blood pressure - tachycardia (increased heart rate) - confusion - depressed level of consciousness (e.g. coma).
Danish: Symptomerne er blandt andet: - nedsat evne til at bevæge sig, dvs. tab af muskelbevægelighed (akinesi) - muskelstivhed - feber - ustabilt blodtryk - øget hjerterytme (takykardi) - forvirring - påvirket bevidsthedstilstand, f.eks koma
English: 67% of patients on pramipexole and 54% of patients on placebo reported at least one adverse drug reaction.
Danish: 67% af patienterne i pramipexolbehandling og 54% af patienterne i placebobehandling rapporterede mindst én bivirkning.
English: Libido disorders Pramipexole may uncommonly be associated with libido disorders (increased or decreased).
Danish: Ændring af libido Pramipexol kan i ikke almindelige tilfælde være forbundet med ændringer i libido (øget eller nedsat).
English: The recommended starting dose of Oprymea is 0.088 mg of base (0.125 mg of salt) taken once daily 2-3 hours before bedtime.
Danish: Den anbefalede startdosis for Oprymea er 0,088 mg base (0,125 mg salt), som tages 1 gang dagligt 2-3 timer før sengetid.
English: Blister (OPA/Alu/desiccant/PE-Alu foil): 10, 30, 90 or 100 prolonged-release tablets, in a box.
Danish: Blister (OPA/alu/tørremiddel/PE-alu): 10, 30, 90 eller 100 depottabletter i en æske.
English: Do not stop taking Oprymea without first talking to your doctor.
Danish: Du må ikke holde op med at tage Oprymea uden at spørge din læge til råds.
English: Pramipexole is bound to plasma proteins to a very low (< 20%) extent, and little biotransformation is seen in man.
Danish: Pramipexol er kun i ringe udstrækning bundet til plasmaproteiner (< 20%), og der er kun set beskeden biotransformation hos mennesker.
English: Swallow whole, do not chew, divide or crush.
Danish: Synkes hele - må ikke tygges, deles eller knuses.
English: If you forget for more than 12 hours, simply take the next single dose at the usual time.
Danish: Hvis der er gået mere end 12 timer, skal du ikke tage den glemte dosis, men blot tage næste dosis på det sædvanlige tidspunkt.
English: Oprymea is not recommended for use in children and adolescents below 18 years since the efficacy and safety has not been established in this population.
Danish: Oprymea anbefales ikke til børn og unge under 18 år, da sikkerhed og virkning ikke er klarlagt hos denne population.
English: Dose adjustment in patients with hepatic failure is not required, as approx. 90% of absorbed active substance is excreted through the kidneys.
Danish: Hos patienter med leversvigt er dosisjustering ikke nødvendig, da ca. 90% af det absorberede aktive stof bliver udskilt via nyrerne.
English: Swallow the tablets whole with water.
Danish: Oprymea tabletter skal synkes hele med vand.
English: Pharmacodynamic effects In human volunteers, a dose-dependent decrease in prolactin was observed.
Danish: Farmakodynamisk virkning Hos frivillige forsøgspersoner fandt man et dosisafhængigt fald i prolaktin.
English: You may experience that symptoms start earlier than usual, be more intense and involve other limbs.
Danish: - Hvis du oplever, at symptomerne ved RLS begynder tidligere på dagen end sædvanligt, er mere intense og omfatter flere legemesdele (dette kaldes augmentation).
English: If a further dose increase is necessary, your doctor may adjust it in steps of 0.26 mg pramipexole.
Danish: Hvis yderligere dosisøgning er nødvendig, vil din læge øge dosis trinvist med 0,26 mg pramipexol.
English: During the first week, the usual dose is 1 tablet Oprymea 0.088 mg three times a day (equivalent to 0.264 mg daily):
Danish: I den første uge er dosis oftest 1 tablet Oprymea á 0,088 mg tre gange dagligt (svarende til 0,264 mg om dagen):
English: The daily dose should not exceed 6 tablets Oprymea 0.088 mg or a dose of 0.54 mg (0.75 mg pramipexole salt).
Danish: Den daglige dosis bør ikke overstige 6 tabletter Oprymea 0,088 mg eller en dosis af 0,54 mg (0,75 mg pramipexolsalt)
English: Intake of a high fat meal induced an increase in peak concentration (Cmax) of about 24% after a single dose administration and about 20% after multiple dose administrations and a delay of about 2 hours in time to reach peak concentration in healthy volunteers.
Danish: Ved indtagelse af fedtholdige måltider hos raske frivillige forsøgspersoner er der set en stigning i plasmakoncentrationen (Cmax) på ca. 24% efter administration af en enklet dosis og ca. 20% efter flere doser.
English: Dose adjustment in patients with hepatic failure is probably not necessary, as approx. 90% of absorbed active substance is excreted through the kidneys.
Danish: Dosisreduktion er sandsynligvis ikke nødvendig for patienter med nedsat leverfunktion, da omkring 90% af det absorberede aktive stof udskilles via nyrerne.
English: Week 1
Danish: Uge 1
English: The tablets should be taken orally, swallowed with water, and can be taken either with or without food.
Danish: Oprymea tabletter bør synkes med vand, og kan både tages sammen med eller uden mad.
English: Because of possible additive effects, caution should be advised when patients are taking other sedating medicinal products or alcohol in combination with pramipexole (see sections 4.4, 4.7 and 4.8).
Danish: Pga. en mulig additiv virkning, bør forsigtighed udvises, når patienter tager andre sedative lægemidler eller alkohol i kombination med pramipexol (se pkt.
English: Common: - Changes in sleep pattern, such as sleeplessness (insomnia) and sleepiness - Tiredness (fatigue) - Headache - Abnormal dreams - Constipation - Dizziness - Vomiting (being sick)
Danish: Almindelig: - Forandring af søvnmønster, såsom søvnløshed (insomni) og søvnighed - Træthed (udmattelse) - Hovedpine - Unormale drømme - Forstoppelse - Svimmelhed - Opkastning
English: Oprymea can cause hallucinations (seeing, hearing or feeling things that are not there).
Danish: Oprymea kan give hallucinationer (du ser, hører eller føler ting, der ikke er der), og det kan påvirke din evne til at køre bil og betjene maskiner.
English: In patients pramipexole alleviates signs and symptoms of idiopathic Parkinson's disease.
Danish: Hos patienter reducerer pramipexol tegn og symptomer på idiopatisk Parkinsons sygdom.
English: TREATMENT INITIATION PACK ONLY PARTICULARS TO APPEAR ON THE OUTER PACKAGING
Danish: GÆLDER KUN FOR BAHANDLINGSSTART PAKKE MÆRKNING, DER SKAL ANFØRES PÅ DEN YDRE EMBALLAGE
English: Oprymea is not recommended for use in children and adolescents below 18 years due to a lack of data on safety and efficacy.
Danish: Sifrol anbefales ikke til børn og unge under 18 år p.g.a. manglende dokumentation for sikkerhed og virkning.
English: Pramipexole alleviates Parkinsonian motor deficits by stimulation of dopamine receptors in the striatum.
Danish: Pramipexol lindrer det motoriske underskud forbundet med Parkinsons sygdom ved stimulation af dopaminreceptorer i corpus striatum.
English: - The other ingredients are hypromellose, maize starch, colloidal anhydrous silica and magnesium stearate.
Danish: - Øvrige indholdsstoffer er hypromellose, majsstivelse, vandfri kolloid silica og magnesiumstearat.
English: Based on the analysis of pooled placebo-controlled trials, comprising a total of 1,778 Parkinson's disease patients on pramipexole and 1,297 patients on placebo, adverse drug reactions were frequently reported for both groups.
Danish: En analyse af poolede placebokontrollerede kliniske forsøg, omfattende 1.778 Parkinsonpatienter i behandling med pramipexol og 1.297 patienter i placebobehandling, viste, at bivirkninger var hyppigt rapporteret i begge grupper.
English: In a double-blind placebo-controlled trial including a total of 517 patients with advanced Parkinson's disease who were on concomitant levodopa therapy superiority of pramipexole prolonged-release tablets over placebo was demonstrated after 18 weeks of treatment on both the primary (UPDRS Parts II+III score) and the key secondary (off-time) efficacy endpoints.
Danish: Et dobbeltblindet, placebokontrolleret studie med 517 patienter med fremskreden Parkinsons sygdom, som samtidig blev behandlet med levodopa, viste, at pramipexol depottabletter havde en bedre virkning (superior) end placebo efter 18 ugers behandling på både det primære (UPDRS del II+III) og vigtigste sekundære (off-time) endepunkter.
English: - Binge eating (eating large amounts of food in a short time period) or compulsive eating
Danish: - Uhæmmet madindtagelse (spise store mængder mad i en kort periode) eller overdreven madindtagelse (spise mere mad end sædvanligt og mere end nødvendigt for at dække sulten)*
English: Boxes of 10, 30, 90 and 100 tablets in blisters of 10 tablets are available.
Danish: Der findes pakninger med 10, 30, 90 og 100 tabletter i blisterpakninger med 10 tabletter i hver.
English: Once Daily Evening Dose (mg of salt)
Danish: 1 gang daglig Aften dosis (mg af salt)
English: Blister (week 1)
Danish: BLISTER (uge 1)
English: Therefore, doses will be expressed in terms of both pramipexole base and pramipexole salt (in brackets).
Danish: Da der i litteraturen refereres til doser af pramipexol i saltformen, er doseringen anført både som pramipexolbase og som pramipexolsalt (i parentes).
English: The expected adverse reactions would be those related to the pharmacodynamic profile of a dopamine agonist, including nausea, vomiting, hyperkinesia, hallucinations, agitation and hypotension.
Danish: De forventede bivirkninger vil relateres til den farmakodynamiske profil for en dopaminagonist herunder kvalme, opkastning, hyperkinesi, hallucinationer, agitation og hypotension.
English: The safety and efficacy of Oprymea in children below 18 years has not been established.
Danish: Oprymeas sikkerhed og virkning hos børn under 18 år er ikke klarlagt.
English: Week 3
Danish: Uge 3
English: A precise frequency estimation is not possible as the side effect did not occur in a clinical trial database of 1,395 patients with Restless Legs Syndrome treated with pramipexole.
Danish: En præcis estimering af frekvens er ikke mulig, da bivirkningen ikke fandtes i en database med data for kliniske forsøg med 1.395 patienter med med Restless Legs syndrom behandlet med pramipexol.
English: Patients and carers should be made aware that behavioural symptoms of impulse control disorders including pathological gambling, increased libido, hypersexuality, compulsive spending or buying, binge eating and compulsive eating can occur in patients treated with dopamine agonists including Oprymea.
Danish: Patienter og pårørende bør informeres om, at adfærdsmæssige symptomer på manglende impulskontrol herunder ludomani, forøget libido, hyperseksualitet, tvangshandlinger, der fører til overdrevent indkøbsmønster og uhæmmet og overdreven madindtagelse, kan forekomme hos patienter i behandling med dopaminagonister, herunder Oprymea.
English: A more frequent adverse drug reaction in combination with levodopa was dyskinesia.
Danish: Dyskinesi ses hyppigere i kombination med levodopa.
English: Based on the analysis of pooled placebo-controlled trials, comprising a total of 1,923 patients on pramipexole and 1,354 patients on placebo, adverse drug reactions were frequently reported for both groups.
Danish: En analyse af poolede placebokontrollerede kliniske forsøg, omfattende 1.923 patienter i behandling med pramipexol og 1.354 patienter i placebobehandling viste, at rapportering af bivirkninger var hyppigt forekommende i begge grupper.
English: The excretion of pramipexole into breast milk has not been studied in women.
Danish: Udskillelsen af pramipexol i human mælk er ikke kendt.
English: If you are taking levodopa, the dose of levodopa is recommended to be reduced when you start treatment with Oprymea.
Danish: Hvis du tager levodopa (medicin mod Parkinsons sygdom), bør dosis nedsættes, når du starter behandling med Oprymea.
English: Very common may affect more than 1 in 10 people
Danish: Meget almindelig Kan forekomme hos flere end 1 ud af 10 patienter Almindelig
English: 3-week treatment initiation pack contains 21 prolonged-release tablets in 3 packages: - the package marked "Week 1" contains 1 blister of 7 tablets of 0.26 mg, - the package marked "Week 2" contains 1 blister of 7 tablets of 0.52 mg, - the package marked "Week 3" contains 1 blister of 7 tablets of 1.05 mg.
Danish: - pakningen markeret ”Uge 2” indeholder 1 blisterark med 7 tabletter indeholdende 0,52 mg, - pakningen markeret ”Uge 3” indeholder 1 blisterark med 7 tabletter indeholdende 1,05 mg
English: 1 tablet Oprymea 0.35 mg and 1 tablet Oprymea 0.18 mg
Danish: 1 tablet Oprymea 0,35 mg og 1 tablet Oprymea 0,18 mg
English: There is no relevant use of Oprymea in the paediatric population for the indication of Parkinson's Disease.
Danish: Det er ikke relevant at anvende Oprymea hos den pædiatriske population ved indikationen Parkinsons sygdom.
English: Blister (week 2)
Danish: BLISTER (uge 2)
English: Blister (week 3)
Danish: BLISTER (uge 3)
English: Stimulation of the dopamine receptors triggers nerve impulses in the brain that help to control body movements.
Danish: Oprymea påvirker nerveimpulser i hjernen, som kontrollerer kroppens bevægelser, ved at stimulere dopaminreceptorerne.
English: Restless Legs Syndrome, most common adverse reactions The most commonly (≥ 5%) reported adverse drug reactions in patients with Restless Legs Syndrome treated with pramipexole were nausea, headache, dizziness and fatigue.
Danish: Almindeligste bivirkninger ved restless legs syndrom De mest almindeligt (≥ 5%) rapporterede bivirkninger hos patienter med restless legs syndrom, behandlet med pramipexol var: kvalme, hovedpine, svimmelhed og træthed.
English: Description of selected adverse reactions
Danish: Beskrivelse af udvalgt bivirkninger
English: In patients with a creatinine clearance between 20 and 50 ml/min, the initial daily dose of Oprymea should be administered in two divided doses, starting at 0.088 mg of base (0.125 mg of salt) twice a day (0.176 mg of base/0.25 mg of salt daily).
Danish: Ved kreatininclearance mellem 20 og 50 ml/min bør initialdosis af Oprymea fordeles på 2 daglige doser begyndende med 0,088 mg base (0,125 mg salt) to gange dagligt svarende til 0,176 mg base (0,25 mg salt) per døgn.
English: Colloidal anhydrous silica Magnesium stearate
Danish: Kolloid, vandfri silica Magnesiumstearat
English: Very common: - Dyskinesia (e.g. abnormal, uncontrolled movements of the limbs) - Sleepiness - Dizziness - Nausea (sickness)
Danish: Meget almindelig: - Unormale, ufrivillige bevægelser (dyskinesi) - Søvnighed - Svimmelhed - Kvalme
English: Symptoms suggestive of neuroleptic malignant syndrome have been reported with abrupt withdrawal of dopaminergic therapy (see section 4.2).
Danish: Symptomer, der ligner malignt neuroleptika syndrom, har været set i forbindelse med pludseligt ophør med dopaminbehandling (se pkt.
English: Oprymea is used to: - treat the symptoms of primary Parkinson's disease in adults.
Danish: Oprymea bruges til: - behandling af voksne patienter med symptomer på Parkinsons sygdom.
English: If you have moderate kidney disease, the usual starting dose is 1 tablet Oprymea 0.088 mg twice a day.
Danish: Hvis din nyresygdom er moderat, er startdosis oftest 1 tablet Oprymea á 0,088 mg 2 gange daglig.
English: Pramipexole is a dopamine agonist that binds with high selectivity and specificity to the D2 subfamily of dopamine receptors of which it has a preferential affinity to D3 receptors, and has full intrinsic activity.
Danish: Det bindes med høj selektivitet og specificitet til undergruppen dopamin D2 receptorerne og har primært affinitet til D3 receptorer.
English: If a further dose increase is necessary, doses should be increased by 0.26 mg pramipexole base at weekly intervals up to a maximum dose of 1.57 mg pramipexole base (2.25 mg of salt) per day.
Danish: Hvis yderligere dosisøgning er nødvendig, bør dosis øges med 0,26 mg pramipexolbase/uge op til en maksimal dosis på 1,57 mg pramipexolbase (2,25 mg salt) daglig.
English: Pramipexole is commonly associated with somnolence and has been associated uncommonly with excessive daytime somnolence and sudden sleep onset episodes (see also section 4.4).
Danish: Det er almindeligt, at pramipexolbehandling er forbundet med døsighed, men det er ikke almindeligt, at det er forbundet med somnolens i dagtimerne og pludseligt opståede søvnepisoder (se også pkt.
English: Patients being treated with Oprymea and presenting with somnolence and/or sudden sleep episodes must be informed to refrain from driving or engaging in activities where impaired alertness may put themselves or others at risk of serious injury or death (e.g. operating machines) until such recurrent episodes and somnolence have resolved (see also sections 4.4, 4.5 and 4.8).
Danish: Patienter, som bliver behandlet med Oprymea, og som har oplevet døsighed, somnolens og/eller episoder med pludseligt opstået søvn, bør informeres om, at de skal afstå fra at køre bil eller deltage i aktiviteter, hvor nedsat årvågenhed kan udsætte dem eller andre for alvorlig fare eller død (f.eks. betjening af maskiner), indtil sådanne tilbagevendende episoder, døsighed og/eller somnolens er ophørt (se også pkt.
English: 21 prolonged-release tablets: EU/1/08/469/054
Danish: 21 depottabletter: EU/1/08/469/054
English: In clinical trials approximately 5% of patients were treated at doses below 1.05 mg of base (1.5 mg of salt).
Danish: Ca. 5% af patienterne i de kliniske forsøg blev behandlet med doser mindre end 1,05 mg base (1,5 mg salt).
English: Store in the original package in order to protect from moisture.
Danish: Opbevares i den originale pakning for at beskytte mod fugt
English: Coadministration of antipsychotic medicinal products with pramipexole should be avoided (see section 4.5).
Danish: Samtidig behandling med antipsykotiske lægemidler og pramipexol bør undgås (se pkt.
English: The most commonly (≥ 5%) reported adverse drug reactions in patients with Parkinson's disease more frequent with pramipexole treatment than with placebo were nausea, dyskinesia, hypotension, dizziness, somnolence, insomnia, constipation, hallucination, headache and fatigue.
Danish: De mest almindeligt ( 5%) rapportede bivirkninger hos patienter med Parkinsons sygdom, som oftere ses efter behandling med pramipexol end efter behandling med placebo er kvalme, dyskinesi, hypotension, svimmelhed, døsighed, søvnløshed, forstoppelse, hallucinationer, hovedpine og træthed.
English: There is no relevant use of Oprymea prolonged-release tablets in the paediatric population for the indication of Parkinson's Disease.
Danish: Det er ikke relevant at anvende Oprymea depottabletter hos den pædiatriske population ved indikationen Parkinsons sygdom.
English: How to take Oprymea
Danish: Sådan skal du tage Oprymea
English: In clinical trials approximately 5% of patients were treated at doses below 1.1 mg of base (1.5 mg of salt).
Danish: Ca. 5% af patienterne i de kliniske forsøg blev behandlet med doser mindre end 1,1 mg (1,5 mg salt).
English: Patients with a creatinine clearance above 50 ml/min require no reduction in daily dose or dosing frequency.
Danish: Ved kreatininclearance over 50 ml/min er reduktion af dosis eller doseringshyppighed ikke nødvendig.
English: 7 tablets of Oprymea 1.05 mg
Danish: 7 tabletter indeholdende Oprymea 1,05 mg
English: In patients with a creatinine clearance less than 20 ml/min, the daily dose of Oprymea should be administered in a single dose, starting at 0.088 mg of base (0.125 mg of salt) daily.
Danish: Ved kreatininclearance mindre end 20 ml/min bør Oprymea gives som en enkeltdosis begyndende med 0,088 mg base (0,125 mg salt) per døgn.
English: Common: - Urge to behave in an unusual way - Hallucinations (seeing, hearing or feeling things that are not there) - Confusion - Tiredness (fatigue) - Sleeplessness (insomnia) - Excess of fluid, usually in the legs (peripheral oedema) - Headache - Hypotension (low blood pressure) - Abnormal dreams - Constipation - Visual impairment - Vomiting (being sick) - Weight loss including decreased appetite
Danish: Almindelig: - Trang til unormal adfærd - Hallucinationer (du ser, hører eller føler ting, som ikke er der) - Forvirring - Træthed (udmattelse) - Søvnløshed (insomi) - Væskeophobning - hævede fødder, ankler og hænder (perifert ødem) - Hovedpine - Lavt blodtryk (hypotension) - Unormale drømme - Forstoppelse - Synsnedsættelse (dobbeltsyn) - Opkastning - Vægttab samt nedsat appetit
English: Oprymea can be taken with or without food.
Danish: Oprymea kan enten tages sammen med mad eller alene.
English: 7 prolonged-release tablets Week 1
Danish: 7 depottabletter Uge 1
English: Within the system organ classes, adverse reactions are listed under headings of frequency (number of patients expected to experience the reaction), using the following categories: very common (≥ 1/10); common (≥ 1/100 to < 1/10); uncommon (≥ 1/1,000 to < 1/100); rare (≥ 1/10,000 to < 1/1,000); very rare (< 1/10,000); not known (cannot be estimated from the available data .
Danish: Bivirkningerne er opført efter systemorganklasse og hyppighed (antal patienter, der forventes, at opleve en bivirkning) ved brug af følgende kategorier: Meget almindelig (≥1/10); almindelig (≥1/100 til <1/10); ikke almindelig (≥1/1.000 til <1/100); sjælden (≥1/10.000 til <1/1.000); meget sjælden (<1/10.000), ikke kendt (kan ikke estimeres ud fra forhåndenværende data.
English: Within the system organ classes, adverse reactions are listed under headings of frequency (number of patients expected to experience the reaction), using the following categories: very common (≥ 1/10); common (≥ 1/100 to < 1/10); uncommon (≥ 1/1,000 to < 1/100); rare (≥ 1/10,000 to < 1/1,000); very rare (< 1/10,000); not known (cannot be estimated from the available data).
Danish: Bivirkningerne er opført efter systemorganklasse og hyppighed (antal patienter, der forventes, at opleve en bivirkning) ved brug af følgende kategorier: Meget almindelig (≥1/10); almindelig (≥1/100 til <1/10); ikke almindelig (≥1/1.000 til <1/100); sjælden (≥1/10.000 til <1/1.000); meget sjælden (<1/10.000); ikke kendt (kan ikke estimeres ud fra forhåndenværende data).
English: Cardiac failure
Danish: Hjerte hjertesvigt
English: The usual maintenance dose is 1.1 mg per day.
Danish: Den daglige vedligeholdelsesdosis er oftest 1,1 mg eller muligvis højere.
English: Most hallucinations are visual - Dyskinesia (e.g. abnormal, uncontrolled movements of the limbs).
Danish: De fleste hallucinationer er syns hallucinationer - Ufrivillige bevægelser af arme og ben (dyskinesi)