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What is Akinesia?

Akinesia

Akinesia is a term for the loss of ability to move your muscles voluntarily. It’s most often described as a symptom of Parkinson’s disease (PD). It can appear as a symptom of other conditions, too.

One of the most common signs of akinesia is “freezing.” This means one or more areas of your body can no longer move as a result of a neurological condition, such as PD. These conditions cause nerve cells (neurons) in your brain’s movement centers to weaken and die. Then the neurons can no longer send signals to nerves and muscles. This can cause you to lose your ability to control your muscles. This can include muscles in your face, hands, legs, or other muscles you use every day.

Akinesia and many of the conditions that cause it are progressive. The majority of conditions are progressive and incurable, but not all of them. Severe hypothyroidism can cause a reversible akinetic syndrome. Drug induced parkinsonism can also potentially be reversed.

Treatments and medications to slow to progression of akinesia and neurological conditions like PD are available. They can help limit the effects akinesia has on your daily life.

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Fetal akinesia

Fetal akinesia

Akinesia can happen to a fetus in the womb. This condition is called fetal akinesia. In these cases, fetuses don't move as much as they’re supposed to. This condition can also happen with other symptoms. A fetus’ lungs may not develop properly or the baby may be born with abnormal facial features. These symptoms are known as fetal akinesia deformation sequence (FADS). It most likely results from their genes.

Akinesia and dykinesia

Akinesia and dyskinesia: What’s the difference?

Akinesia is different from dyskinesia. Dyskinesia can happen with conditions in which your muscles twitch or move involuntarily. In akinesia, you are unable to direct your muscles to move (sometimes entirely). But the muscles do not lose their abilities. It’s the extrapyramidal system or movement centers that are faulty.

In dyskinesia, your muscles may move unexpectedly or constantly without the ability to stop. Like akinesia, dyskinesia can also happen in conditions like PD.

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Symptoms

Symptoms

The most recognizable symptom of akinesia is “freezing.” This can make you feel stiff in one or more muscle groups. It can make your face look like it’s frozen in one facial expression. It can also make you walk with a distinct rigid movement known as “gait freezing.”

This symptom also happens because of a condition called progressive supranuclear palsy (PSP), which tends to affect walking and balance earlier than in PD. Other symptoms that may appear along with akinesia if you have PD include:

  • shaking of muscles (tremors) in your hands and fingers, especially when you’re resting or distracted
  • softening of the voice or slowed speech
  • not being able to stand up straight or maintain a certain posture
  • moving slowly and taking longer to finish physical tasks (bradykinesia)

Symptoms of PSP that may appear along with akinesia (especially in the face) include:

  • losing vision or having blurred vision
  • not being able to move the eyes very quickly
  • not being able to look up and down easily
  • not being able to keep eye contact for very long
  • having trouble swallowing
  • having symptoms of depression, including mood swings

Treatment

Treatment

Medications

One of the most common treatments for akinesia as a result of PD is a mix of levodopa, a central nervous system agent, and carbidopa. Carbidopa helps keep the side effects of levodopa, like nausea, from being too severe.

Akinesia in PD can happen as a result of a lack of dopamine. Your brain produces dopamine and passes it along into your body by neurons. Levodopa helps treat akinesia and other PD symptoms because your brain turns it into dopamine. It can then be carried into your body to help relieve the muscle stiffness of akinesia and the tics and tremors of other PD symptoms.

Levodopa and carbidopa can interact with other medications and have some severe side effects. Talk to your doctor about how this treatment might affect you before you start taking these medications.

MAO-B inhibitors also help stop dopamine from being naturally degraded by your body’s enzymes. This also increases the amount of dopamine that’s available to combat akinesia and slow the progress of PD.

Medications aren’t usually effective in treating akinesia that results from PSP. Antidepressants can help relieve akinesia and depressive symptoms that can result from PSP. Injections of botulinum can also help address symptoms such as involuntary eyelid closing (blepharospasm).

Implantable stimulators

If the standard medications are wearing off sooner or not having the desired effect on the akinesia, doctors may discuss the possibility of surgically implanting electrodes to stimulate movement centers. This treatment helps with symptoms in more advanced cases. This is called deep brain stimulation. It’s a technique used more and more in PD.

There are advantages and limitations. Talk with your doctor to see if they’d recommend this treatment for you.

Over-the-counter

Akinesia can cause pain as well as stiffness, and taking medications for PD or PSP can cause pain and discomfort. Taking over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and acetaminophen can help reduce some of the pain that PD, PSP, or their associated medications can cause.

Alternative and home treatments

Getting regular exercise can help you reduce the pain and discomfort that can happen with akinesia and other motor function conditions that may result from PD or PSP. Talk to your doctor or a physical therapist about developing an exercise plan that’s comfortable and safe for you depending on your symptoms and the progression of akinesia. Making sure that you don't overexert yourself or fall during exercise is important. Doing yoga or tai chi, which help stretch your muscles, can help slow the progression of akinesia. Exercise has been shown to delay functional decline in PD.

Taking coenzyme Q10 for several months can help you if you’re in the early stages of PD or PSP. Eating foods with a lot of fiber and drinking plenty of water (at least 64 ounces per day) can help keep your symptoms to a minimum.

Treatments that help relax your muscles, such as massages and acupuncture, can also relieve the symptoms of PD and PSP. Meditating or doing activities that relax you, such as listening to music or painting, can help slow the effects of akinesia and help you retain control over your muscles.

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Causes and risk factors

Causes and risk factors

Akinesia that results from PD and PSP doesn’t always have an obvious cause because these conditions can be caused by a combination of your genes and your environment. It’s also thought that bunches of tissue in your brain called Lewy bodies may contribute to PD. A protein in these Lewy bodies, called alpha-synuclein, may also play a part in causing PD.

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Outlook

Outlook

Akinesia and many of the conditions that cause it don’t yet have a cure. But many medications, therapies, and lifestyle changes can help keep you active and able to do daily tasks.

New research about PD, PSP, and other related conditions emerges each year, especially on Lewy bodies and other biological features that may cause these conditions. This research may bring doctors and scientists closer to understanding how to treat and cure akinesia and its causes.

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