Akinesia

Akinesia Definition

Akinesia is a medical disorder characterized by impaired muscle movements. It comes from the Greek word “kinesis” which means body movement and the prefix “a”, which means absence. Akinesia can affect a particular part of the body or all parts of the body. In neurology, Akinesia is categorize as a motor disorder. (1, 2)


What are the causes of Akinesia?

Akinesia causes are vast. It is caused by a multitude of problems involving the nervous system. It is associated with problems affecting the frontal lobe, which is the movement control center of the body. Some of the causes include the following:

  • Medical conditions – Some medical condition can cause akinesia such as Parkinson’s disease, although it is not yet clear how the disease affects the normal function of the nerve.
  • Trauma/injury to the brain – An injury affecting the basal ganglia of the brain could lead to akinesia.
  • Side effects of medications – Some medications can have drastic effects to the normal functioning of the body. Antipsychotics, especially those drugs given to patient with severe paranoia and schizophrenia have symptoms similar to Parkinson’s disease such as akinesia. The abnormalities in movement usually occurs several weeks after starting antipsychotic medications. (2, 3)
  • Use of street drugs – illicit drugs such as synthetic heroin can cause symptoms similar to that of Parkinson’s disease including akinesia.
  • Shy-Drager syndrome – This condition causes deterioration in the patient’s body. The patient could suffer from akinesia and other symptoms similar to Parkinson’s disease.
  • Blood vessel syndrome – Medical conditions that primarily involve the blood vessels could cause akinesia. Examples are stroke and atherosclerosis. (3)

A radiologic view of fetal akinesia.photo

Image 1 : A radiologic view of fetal akinesia
Picture Source : www.fetalultrasound.com

A patient with akinesia being taken care of by a significant other. It also outlines the possible causes of akinesia.photoFigure 2 : A patient with akinesia being taken care of by a significant other. It also outlines the possible causes of akinesia
Picture Source : www.epainassist.com

Akinesia Symptoms

  • Decrease or total loss of motor functions
  • Apathy (lack of interest to the surroundings)
  • Decreased in spontaneous movement and reflexes
  • The patient’s face is fixed and does not have expression at all
  • Speech is monotonous and without modulation
  • The patient rarely blinks the eyelids
  • Patient is completely immobile (severe cases)
  • The patient gets easily tired when asked to do repetitive actions
  • Inability to perform normal task including sequential and simultaneous actions. (4, 5,6)

Difference between bradykinesia, akinesia and dyskinesia?

Dyskinesia pertains to difficulty in performing voluntary movements. The movement looks like an uncoordinated dance. It is caused by antipsychotics and levodopa. To significantly improve the condition of the patient, the dose of antipsychotics is significantly reduced.

On the other hand, bradykinesia pertains to a slow body movement. It is common in people with Parkinson’s disease. The body movement is too slow that even just simple buttoning of shirt requires so much time. The reaction time is slow too. The speech can also be affected. People with severe bradykinesia have soft speech, which makes it difficult for other people to understand what they are saying. (6, 7)

Akinesia caused by extrapyramidal symptoms (EPS)

Extrapyramidal symptoms (EPS) pertains to side effects of antipsychotics, especially drugs used to treat schizophrenia. A perfect example is Haldol. In EPS, the control of extrapyramidal system is disturbed. The primary reason is dopamine blockage.

Dopamine is the one that controls the extrapyramidal system. Antipsychotics like Haldol blocks dopamine, which leads to a reduction in dopamine level, which helps in the treatment of schizophrenia. (8)

Fetal Akinesia Syndrome

It is characterized by lack of fetal movement. There are a number of reasons for lack of fetal movement, but the bottom line is that it could lead to akinesia or inability to initiate body movement.

Lack of fetal movement could possibly be due to rocker-bottom feet, pulmonary hypoplasia, facial anomalies, and ulnar deviation of the hands. Pulmonary hypoplasia is one of the leading causes of stillborn and infant death shortly after birth. (8)

Akinesia Treatment

Treatment for akinesia primarily focuses on symptomatic relief and management and improving the way of life of the patient. The patient’s significant others should actively take part in the patient’s treatment as they will be the one to provide optimal patient care. There are three major treatment components. They are the following:

  1. Pharmacologic approach – Various drugs should be used to treat or somehow reduce the symptoms of akinesia. These include:Dopamine agonist –Examples of dopamine agonist drugs are Requip and Neupro. This drug stimulates the dopamine receptors in the brain. The patient should take a therapeutic level of dopamine at a certain hour of the day to significantly reduce akinesia.
    Levodopa – It is a PDI drug or peripheral decarboxylase inhibitor. It is the drug of choice for Parkinson’s disease and associated symptoms like akinesia.
    L-DOPS (L-threo-dihydroxyphenylserine; Droxidopa) – This is primarily helpful in people suffering from pure akinesia. The symptoms of patients with akinesia will significantly improve after taking L-DOPS.
  2. Supportive management – People with akinesia, especially those suffering from pure akinesia is prone to accident and injury. It is very important for the significant others to actively take part in taking care of the patient. The patient’s movement is impaired or altered. The patient’s motor control is not at par. Therefore, family members should constantly monitor the patient to prevent any forms of injury. If the patient is lying down, make sure you put the side rails up to prevent from falling.
  3. Physical Therapy – The purpose of physical therapy is to improve the quality of life of patients suffering from akinesia. Patients with Parkinson’s disease have akinesia. The good news is there are a number of physical therapies designed for the symptomatic relief of akinesia. Physical therapy for akinesia aims to improve or normalize the muscle activity of the patient. There are physical therapy sessions that aim to lessen the episodes of freezing in movement, especially when the patient is turning. Some studies revealed that a patient who trains in a rotating treadmill will be able to see a significant improvement in akinesia and Parkinson’s disease as a whole. (8, 9,10)

References:

  1. https://rarediseases.info.nih.gov
  2. byebyedoctor.com
  3. www.epainassist.com
  4. diseasespictures.com
  5. www.allhealthsite.com
  6. www.parkinsonswa.org.au
  7. www.neurology.org
  8. https://radiopaedia.org
  9. www.fpnotebook.com
  10. Neurology in Clinical Practice: Principles of diagnosis and management, Volume 1 edited by Walter George Bradley

Published by under Diseases and Conditions.
Article was last reviewed on September 30th, 2017.

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