What is hypokinesia?
Hypokinesia is a type of movement disorder. It specifically means that your movements have a “decreased amplitude” or aren’t as big as you’d expect them to be.
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 referred to under the term bradykinesia. These movement disorders are often equated with Parkinson’s disease.
Hypokinesia is the flip side of the term hyperkinesia. Hypokinesia occurs when you have too little movement, and hyperkinesia occurs when you have too many involuntary movements.
What are the symptoms?
Hypokinesia is often seen together with akinesia and bradykinesia. Along with motor control trouble, this combination of problems can also come with various non-motor symptoms. These combinations of symptoms are usually associated with Parkinson’s disease.
Unusual movements can show up in different parts of your body in different ways.
Some possibilities include:
- non-expressive look on your face (hypomimia)
- decreased blinking
- blank stare in your eyes
- soft speech (hypophonia) with loss of inflection (aprosody)
- drooling because you stop swallowing automatically
- slow shoulder shrug and arm raise
- uncontrolled shaking (tremor)
- small, slow handwriting (micrographia)
- decreased arm swing when walking
- slow, small movements when opening and closing your hands or tapping your fingers
- poor dexterity for shaving, brushing teeth, or putting on makeup
- slow, small movements when stomping your feet or tapping your toes
- flexed-forward posture
- slow, shuffling gait
- difficulty getting started or freezing during movements
- difficulty rising from a chair, getting out of your car, and turning in bed
Mental and physical symptoms not specifically caused by hypokinesia often come hand-in-hand with hypokinesia and Parkinson’s disease.
- loss of ability to multi-task and concentrate
- slowness of thought
- onset of dementia
- psychosis or other psychiatric conditions
- sleep disturbances
- low blood pressure when standing
- unexplained pain
- loss of smell
- erectile dysfunction
- numbness or a feeling of “pins and needles”
What conditions cause hypokinesia?
Hypokinesia is most often seen in Parkinson’s disease or Parkinson-like syndromes. But it can also be a symptom of other conditions:
Schizophrenia and other cognitive conditions often come with motor function problems like hypokinesia. These movement disorders may happen because different parts of the brain don’t “talk” to one another correctly.
Dementia with Lewy bodies is a form of dementia. Symptoms can include visual hallucinations, cognitive problems, movement disorders like hypokinesia, repeated falls, fainting, delusions, sleep disorders, and depression.
Multiple system atrophy is a group of nervous system disorders that causes hypokinesia, incoordination, speech changes, stiffness, weakness, erectile dysfunction, urinary problems, and dizziness when standing up.
Progressive supranuclear palsy is a disorder with motor symptoms similar to Parkinson’s. The condition’s hallmark is an inability to move your eyes up and down; you may also have trouble keeping your eyelids open. You may have trouble with speech and swallowing, and you may think slowly.
Cortical basal ganglionic degeneration is a rare Parkinson-like disorder. You may have rigidity on one side of your body, painful muscle contractions, and speech problems. Sometimes your arm or leg will move without you “telling” it to.
What treatment options are available?
You have many options for easing symptoms and improving your quality of life if you have hypokinesia or another movement disorder related to Parkinson’s disease. A typical treatment plan may include medication, deep brain stimulation, and physical therapy.
However, there isn’t a medication or treatment available at this time that can slow or stop the disease’s progression.
Most of the medications to treat motor symptoms of Parkinson’s increase the levels of dopamine in your brain. Other types of medications and therapies are used to treat non-motor symptoms.
Common options include:
Levodopa is converted to dopamine in your brain and is the most effective medication for hypokinesia related to Parkinson’s disease. It’s usually combined with carbidopa (Lodosyn), which is a medication that prevents the breakdown of levodopa in the body so more reaches the brain.
Dopamine agonists are another type of medication that increase your dopamine levels. They can be combined with levodopa. These medicines include bromocriptine (Parlodel), pergolide (Permax), pramipexole (Mirapex), and ropinirole (Requip).
Monoamine oxidase (MAO)-B inhibitors slow the breakdown of dopamine in the brain. They allow your body’s available dopamine to work longer. These medications include selegiline (Eldepryl) and rasagiline (Azilect).
Catechol-O-methyltransferase (COMT) inhibitors slow the breakdown of levodopa in the body, allowing more levodopa to reach the brain. These medications include entacapone (Comtan) and tolcapone (Tasmar).
Anticholinergic drugs decrease the brain chemical acetylcholine and help restore balance between acetylcholine and dopamine. These medications include trihexyphenidyl (Artane) and benztropine (Cogentin).
Amantadine (Symmetrel) works in two ways. It increases dopamine activity in your brain. It also affects the glutamate system in your brain, reducing uncontrolled body movements.
Deep brain stimulation (DBS) is a surgical option if other therapies are not working well for you. It works best to reduce stiffness, slowness, and tremor.
You and your doctor will go over any other non-movement symptoms you may have, like cognitive troubles, fatigue, or sleep problems. Together you can come up with a treatment plan that includes medications and other therapies to ease those symptoms.
Your doctor may also recommend physical therapy, occupational therapy, use of assistive devices, or counseling.
Can hypokinesia lead to any other movement disorders?
Several types of movement challenges are seen together with hypokinesia’s small movements. These unusual motor patterns are often found in someone with Parkinson’s disease or one of the Parkinson-like syndromes.
Akinesia: If you have akinesia, you will have difficulty with or inability to initiate movement. Your muscle stiffness often begins in the legs and neck. If akinesia affects your face muscles, you may develop a mask-like stare.
Bradykinesia: If you have bradykinesia, your movements will be slow. Over time, you may start to “freeze” in the middle of a movement and it may take you a few seconds to get going again.
Dysarthria: If you have dysarthria, the muscles you use to talk will be weak or you’ll have a hard time controlling them. Your speech may be slurred or slow and others may find it hard to understand you.
Dyskinesia: If you have dyskinesia, you will have uncontrolled movements. It may affect one body part — like your arm, leg, or head — or it may affect muscles throughout your body. Dyskinesia may look like fidgeting, wriggling, swaying, or head bobbing.
Dystonia: If you have dystonia, you will have painful, long muscle contractions that cause twisting movements and unusual body postures. The symptoms usually begin in one area of the body but may spread to other areas.
Rigidity: If you have rigidity, one or more of your limbs or other body parts will be unusually stiff. It is one telltale feature of Parkinson's disease.
Postural instability: If you have postural instability, you will have trouble with balance and coordination. This can make you unstable when standing or walking.
What’s the outlook?
There is no cure for hypokinesia. Parkinson’s is also a progressive disease, meaning it will get worse over time. But you can’t predict which symptoms you’ll get or when you’ll get them. Many symptoms can be relieved by medications and other therapies.
Each person’s experience with hypokinesia and Parkinson’s disease is different. Your doctor is your best resource for information about your individual outlook.