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Sunday, December 10, 2017

All you need to know about akinesia

Sun 10 December 2017 - By Rachel Nall, RN, BSN, CCRN


Akinesia is a disease symptom that causes a person to lose the ability to move their muscles on their own. Sometimes a person's body feels as if it is "frozen" in time.



Doctors commonly associate akinesia with Parkinson's disease, which causes someone to lose control of their movements. However, there are other medical causes connected with akinesia.
Babies in the womb can experience akinesia, which in turn impacts their development. Movement is an important part of fetal development, and akinesia can affect growth and maturation in the womb.
Fast facts on akinesia:
  • Akinesia is a condition that can occur at any age.
  • It is sometimes referred to as "freezing."
  • In Parkinson's disease, akinesia is usually a symptom of later stages.

What are the symptoms?

Some of the symptoms associated with akinesia include:
  • Difficulty when a person starts out to walk somewhere.
  • Muscle rigidity, usually beginning in the neck and legs. Muscles in the face can become rigid, similar to a mask.
  • Sudden inability to move the feet properly, especially when turning or approaching a destination.
Not all people with Parkinson's disease have the same symptoms. Doctors often use the acronym TRAP to describe the symptoms of Parkinson's disease. These stand for:
  • Tremor at rest
  • Rigidity
  • Akinesia
  • Postural instability
A person with Parkinson's may display some or all of these symptoms. However, according to a study in the Journal of Neurology, Neurosurgery & Psychiatry, 47 percent of more than 6,600 people with Parkinson's disease who responded to a questionnaire reported akinesia or freezing as a symptom.
It is also possible that a person can experience akinesia on its own with no underlying signs of Parkinson's disease.
One such instance of akinesia is known as "pure" akinesia with so-called gait-freezing. This symptom does not have the other accompanying Parkinson's symptoms of resting tremors, generalized slower movements, or rigidity.

What is fetal akinesia deformation sequence?

Fetal akinesia deformation sequence (FADS) involves a type of akinesia that causes a combination of abnormalities in the womb when a baby is developing.
Examples of these symptoms include:
  • joint contractures
  • facial anomalies
  • intrauterine growth restriction (IUGR)
  • underdeveloped lungs
According to the National Center for Advancing Translational Sciences, an estimated 30 percent of those with FADS are stillborn.
Others may not survive for long outside of the womb due to problems associated with their underdeveloped lungs.

Difference between akinesia and dyskinesia

Akinesia and dyskinesia are both symptoms that describe disorders in movement.
Akinesia is the absence of movement. A person with akinesia cannot move their muscles, even if they try.
A person with dyskinesia or difficulty in movement has muscles that move involuntarily and unexpectedly. Examples can include tremors or shaking or spastic movements, which can appear like sudden jerking movements.
Both symptoms can occur when a person has Parkinson's disease.

Risk factors for akinesia

In adults, some of the causes associated with akinesia include:
  • Parkinson's disease: This results in reduced amounts of dopamine produced in the brain, affecting a person's ability to control their muscles.
  • Medication-induced Parkinson's-like symptoms: Where a person takes too much of a medication that inhibits dopamine.
  • Progressive supranuclear palsy (PSP): A gradual brain-damaging condition that usually first affects balance while walking.
  • Hormone levels: Hypothyroidism or severely low levels of the thyroid hormone can result in akinesia.
In people with Parkinson's disease, men are more likely to have akinesia than women. Those who have a resting tremor as the predominant symptom of their Parkinson's disease are less likely to have akinesia than others.
Other risk factors include:
  • history of bradykinesia or slowed muscle movements
  • having Parkinson's disease for a long time
  • postural instability
  • problems with muscle rigidity
Potential causes of FADS include:
  • abnormalities in nervous system development
  • connective tissue disorders, such as chondrodysplasias
  • fetal edema
  • a history of maternal illness or drug use
Any changes or alterations in the womb that cause insufficient blood flow and oxygen levels to reach the developing fetus can result in fetal akinesia.

Genetic causes

Doctors have also isolated two gene mutations that are associated with increased risks for fetal akinesia.
If a person has a history of family members or babies with the condition, they may wish to see a genetic specialist. By doing so, they can be tested for the gene mutations DOK7 and RAPSN that are associated with akinesia.
Treatments
Treatment depends on what is causing the akinesis symptoms in someone. For example, medication-related akinesia can be treated by stopping taking the medication that is causing the problem.
Treatments for Parkinson's disease-related akinesia can be more complicated. Doctors will often prescribe medications that increase the amount of the neurotransmitter dopamine in the body or the activity it causes. These can help, as reduced levels of dopamine cause the neuromuscular symptoms that are associated with Parkinson's disease.
Examples of these medicines include levodopa and carbidopa, as well as MAO-B inhibitors and dopamine agonists.
When to see a doctor
Seeking treatment for akinesia is necessary as having the symptoms increases the likelihood of a person falling. This can lead to bone breakages and other injuries.
People with Parkinson's disease or other disorders may wish to see a physical therapist, who can help them learn to work past "freezing" episodes and try to continue moving in a safer way whenever possible.
Currently, there are no treatments for PSP or fetal akinesia other than supportive care. However, support could include help with breathing for babies born with akinesia whose lungs are not well developed or working fully.
Takeaway
Akinesia is a difficult symptom to experience for anyone whatever their age. Losing the ability to engage in controlled movements can be devastating for a person with Parkinson's disease or another underlying disorder that causes this to happen.
If a person starts displaying akinesia or any other related symptoms, they should talk to their doctor. Sometimes a person with Parkinson's disease can have acute episodes of akinesia that can be treated for a short time to reduce sudden attacks.
In others cases, akinesia can represent the progression to more severe Parkinson's disease forms or pure akinesia from something other than Parkinson's disease.
https://www.medicalnewstoday.com/articles/320291.php?utm_source=newsletter&utm_medium=email&utm_campaign=daily-us

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