Hypokinesia: Definition, Symptoms, Causes and Treatment

It refers to the decrease of body movement.

Hypokinesia is a type of movement disorder . It means specifically that your movements have a “decreased amplitude” or that they are not as large as you would expect.

Hypokinesia is related to akinesia , which means absence of movement, and bradykinesia , which means slowness of movement. The three terms are often grouped together and are referred to under the term bradykinesia. These movement disorders are often equated with Parkinson’s disease.

Hypokinesis is the other side of the term hyperkinesia. Hypokinesia occurs when you have very little movement, and hyperkinesia occurs when you have too many involuntary movements.

symptom

Hypokinesia is often seen together with akinesia and bradykinesia. Along with motor control problems, this combination of problems can also come with several non-motor symptoms. These combinations of symptoms are usually associated with Parkinson’s disease.

Motor symptoms:

Unusual movements can appear in different parts of your body in different ways. Some possibilities include:

  • Non expressive look on his face (hypomimia).
  • Decrease in flicker.
  • Look blank in your eyes.
  • Speak softly (hypophony) with loss of inflection.
  • Drooling because it stops swallowing automatically.
  • Shrug your shoulders and raise your arm slowly.
  • Uncontrolled shaking (tremor).
  • Decreased arm swing when walking.
  • Slow and small movements when opening and closing the hands or touching with the fingers.
  • Little skill to shave, brush your teeth or put on makeup.
  • Slow and small movements when stomping or touching the toes.
  • Flexed posture.
  • Slow pace and shuffling.
  • Difficulty starting or freezing during movements.
  • Difficulty getting up from a chair, getting out of your car and turning in bed.

Non-motor symptoms:

Physical and mental symptoms not caused specifically by hypokinesia often come hand in hand with hypokinesia and Parkinson’s disease. These include:

  • Loss of ability to multitask and concentrate.
  • Slowness of thought.
  • Start of dementia.
  • Depression .
  • Anxiety.
  • Psychosis or other psychiatric conditions.
  • Sleep disorders.
  • Fatigue.
  • Low blood pressure when standing.
  • Constipation .
  • Unexplained pain.
  • Loss of smell
  • Erectile dysfunction .
  • Numbness or a feeling of “pins and needles.”

What conditions cause hypokinesia?

Hypokinesia is seen more frequently in Parkinson’s disease or Parkinson’s-like syndromes. But it can also be a symptom of other conditions:

Schizophrenia:  often comes with problems of motor function such as hypokinesia. These movement disorders can occur because different parts of the brain do not “speak” to each other correctly.

Dementia: with Lewy bodies is a form of dementia. Symptoms may include visual hallucinations, cognitive problems, movement disorders such as hypokinesia, repeated falls, fainting, delusions, sleep disturbances, and depression.

Multisystemic atrophy: is a group of nervous system disorders that cause hypokinesia, incoordination, changes in speech, stiffness, weakness, erectile dysfunction, urinary problems and dizziness when standing.

Progressive supranuclear palsy: is a disorder with motor symptoms similar to Parkinson’s.

The hallmark of the condition is the inability to move the eyes up and down. You may also have trouble keeping your eyelids open. You may have trouble speaking and swallowing, and you may think slowly.

stroke: rarely causes hypokinesia or other movement disorder. When it occurs, hypokinesia after stroke usually improves after 6 to 12 months.

ganglionar egeneración cortical basal: it is a rare disorder similar to Parkinson ‘s . You may have stiffness on one side of your body, painful muscle contractions and speech problems. Sometimes your arm or leg will move without you “telling” it.

Treatment

You have many options to relieve symptoms and improve your quality of life if you have hypokinesia or another movement disorder related to Parkinson’s disease. A typical treatment plan may include medications, deep brain stimulation and physiotherapy.

However, there is no medication or treatment available at this time that can slow or stop the progression of the disease.

Most medications to treat the motor symptoms of Parkinson’s increase the levels of dopamine in the brain. Other types of medications and therapies are used to treat non-motor symptoms.

Common options include:

  • Levodopa: it is converted into dopamine in the brain and is the most effective medication for hypokinesia related to Parkinson’s disease. It is usually combined with carbidopa (Lodosyn), which is a medication that prevents the breakdown of levodopa in the body, so it reaches more to the brain.
  • Dopamine agonists: are another type of medication that increases your dopamine levels. They can be combined with levodopa. These medications include bromocriptine (Parlodel), pergolide (Permax), pramipexole (Mirapex), and ropinirole (Requip).
  • Monoamine oxidase inhibitors:  reduce the speed of the breakdown of dopamine in the brain. They allow the available dopamine in your body to work longer. These medications include selegiline (Eldepryl) and rasagiline (Azilect).
  • Inhibitors of Catecol-O-methyltransferase:  reduce the rate of the decomposition of levodopa in the body, allowing more levodopa to reach the brain. These medications include entacapone (Comtan) and tolcapone (Tasmar).
  • Anticholinergic drugs: they diminish the chemical acetylcholine of the brain and help to restore the balance between acetylcholine and dopamine. These medications include trihexyphenidyl (Artane) and benztropine (Cogentin).
  • Brain stimulation: it  is a surgical option if other therapies do not work well for you. It works best to reduce stiffness, slowness and tremor.

You and your doctor will review any other symptoms of non-movement you may have, such as cognitive problems, fatigue or trouble sleeping. Together, they can devise a treatment plan that includes medications and other therapies to alleviate those symptoms.

Your doctor may also recommend physical therapy, occupational therapy, use of assistive devices or advice.

Can hypokinesia lead to other movement disorders?

Several types of movement challenges are seen along with small movements of hypokinesia. These unusual motor patterns are often found in someone with Parkinson’s disease or one of Parkinson’s syndromes.

  • Acinesia : if you have akinesia, you will have difficulty or inability to start the movement. Muscle stiffness often begins in the legs and neck. If the akinesia affects the facial muscles, you can develop a look similar to a mask.
  • Bradicinesia : if you have bradykinesia, your movements will be slow. Over time, it may begin to “freeze” in the middle of a movement and may take a few seconds to restart.
  • Dysarthria : if you have dysarthria, the muscles you use to speak will be weak or you will have difficulty controlling them. Your speech may be diffuse or slow and others may find it difficult to understand.
  • Dyskinesia : if you have dyskinesia, you will have uncontrollable movements. It can affect a part of the body, such as the arm, leg or head, or it can affect the muscles of the whole body. Dyskinesia may seem restless, writhing, swaying or shaking your head.
  • Dystonia:  if you have dystonia, you will have painful and long muscle contractions that cause torsional movements and unusual bodily postures. Symptoms usually begin in one area of ​​the body but can spread to other areas.
  • Rigidity: if you have stiffness, one or more of your extremities or other body parts will be unusually stiff. It is a revealing feature of Parkinson’s disease.
  • Postural Instability: If you have postural instability, you will have problems of balance and coordination. This can make it unstable when standing or walking.
  • Freezing: this is characterized by the inability to move the muscles in any desired direction.
  • Neuroleptic malignant syndrome: As a result of heavy exposure to drugs that block dopamine receptors, victims may experience fever, stiffness, changes in mental status, dysautonomia, tremors, dystonia, and myoclonus.