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Bradykinesia

Bradykinesia Treatment in Delhi, India

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Overview

Bradykinesia is a medical term used to describe a slowness of movement or a significant reduction in the speed of voluntary activities. Mainly, this disease is related to Parkinson's disease as it is considered the most common symptom of this disease. It also depicts the side effects of certain medications. The difficulty in initiating movement can impact the ability of the individuals to carry out activities of daily living.

Symptoms

The main symptom of bradykinesia is slowness in body movements. However, there are other symptoms also which are common among the patients with this issue:

  • Small cramped handwriting
  • Shuffling step when walking
  • Soft speech – Hypophonia
  • Loss of facial expression – Hypomimia
  • Difficulty in assessing fine motor skills
  • Reduced arm swings when walking
  • Dragging one or both feet while walking
  • Difficulty in conducting tasks that are repetitive in nature, such as clapping
  • Difficulty in doing daily tasks such as brushing teeth, doing hair, buttoning clothes, etc. 

People with bradykinesia lose their ability to talk coherently. Over time, their voice becomes softer, due to which others find it difficult to comprehend what they are talking about. It also increases the chance of falling in Parkinson's disease patients.

Causes

Some of the common causes include-

  • Parkinson's Disease: It affects the dopamine-producing cells in the brain. Bradykinesia is a cardinal symptom of Parkinson's disease, along with resting tremors and muscle rigidity.
  • Parkinsonism: This term refers to a group of disorders that have similar symptoms to Parkinson's disease, including bradykinesia. These conditions may be caused by different underlying factors, such as vascular problems or certain medications.
  • Medications: Some medications, particularly antipsychotic drugs and certain antiemetic drugs, can induce bradykinesia as a side effect. This condition is often referred to as drug-induced Parkinsonism.
  • Cerebral Palsy: People with cerebral palsy can experience bradykinesia due to damage to the brain's motor control centers. 
  • Wilson's Disease: It is a rare genetic disorder that leads to an accumulation of copper in the body, affecting various organs, including the brain. This buildup of copper can cause neurological symptoms, including bradykinesia.
  • Huntington's Disease: Huntington's disease is a hereditary genetic disorder that leads to the degeneration of brain cells. It can cause movement problems, including bradykinesia.
  • Multiple System Atrophy (M.S.A.): M.S.A. is a rare neurodegenerative disorder that can cause various motor symptoms, including bradykinesia. It is often challenging to differentiate from Parkinson's disease because of the similar symptoms.
  • Other Neurological Disorders: Some other neurological conditions, such as progressive supranuclear palsy and corticobasal degeneration, can also lead to bradykinesia.
  • Vascular Causes: Stroke or other vascular issues affecting the brain can result in bradykinesia if the regions responsible for motor control are affected.

Diagnosis

The bradykinesia akinesia incoordination test, commonly known as the B.R.A.I.N. test, is a test used to diagnose bradykinesia. While conducting this test, the patients are asked to tap the buttons of a keyboard by using alternative figures within a minute. The scores on this test help in determining the diagnosis. The number of correct keys struck, the number of incorrect keys hit, the time it takes to strike the keys, and the time between striking each key are all factors in the scoring.

This test is regarded to be accurate in determining the stage of Parkinson's disease and whether or not a patient has bradykinesia. There is no standard test for diagnosing Parkinson's disease at this time.

The diagnosis of bradykinesia in a patient can be made using rapid alternating movements in the upper and lower extremities. The examiner looks for a decrease in the pace and/or amplitude of movement during these motions. The following tests help in determining Bradykinesia:

  • Heel tapping
  • Toe-tapping
  • Fist tapping
  • Finger tapping
  • Supination of the hand

Treatment

The symptoms of Parkinson's disease are not meant to be cured. With medication, the symptoms can be managed only. The most helpful medication for Bradykinesia, on the other hand, increases dopamine action. The medications that are likely to use dopamine are as follows:

  • MAO-B inhibitors
  • Dopamine agonists
  • Carbidopa-levodopa

The doctors are likely to try a number of medications on the patients until they find the right one for the patients. Because these sorts of drugs grow less effective with time, finding the proper prescription will be an ongoing task.

The surgical procedure, which is named deep brain stimulation, is also used in treating patients with Parkinson's. This procedure entails surgically implanting electrodes in particular areas of the brain. Electrical impulses will be transmitted to stimulate the brain at the electrode locations after the electrodes are in place. This treatment is usually reserved for those with advanced Parkinson's disease who haven't responded well to other treatments.

Some home remedies can also be included in the treatment plan for Bradykinesia. Some of these home remedies include:

  • Walking
  • Swimming
  • Eating a diet with high fibre
  • Eating a nutrient-rich diet
  • Avoid falling

Complication:

Individuals who are dealing with Parkinson's disease may experience serious complications which directly impact their mobility in a negative way. Patients with Bradykinesia may experience this slowness in different ways:

  • Difficulty in automatic movements, such as swinging arms when walking
  • Difficulty in initiating movements like getting out of a chair easily
  • Reduction of speed in conducting physical actions
  • Abnormal stillness
  • Decreased facial expression

This disease has been recognized as particularly frustrating because of its unpredictable nature. A patient may be able to move freely one minute and require assistance the next.

Risk factors

Bradykinesia is most commonly associated with Parkinson's disease, which has a higher prevalence in both men and women. However, men are more frequently affected by this condition than women. Age is a significant risk factor for Parkinson's disease, with the majority of cases occurring around the age of 60, although 5 to 10% of individuals with the disease develop it before the age of 50. While Parkinson's disease often has a genetic component, not all cases are hereditary, and specific gene mutations have been linked to certain forms of the disease.

Prognosis

There is currently no treatment which can omit bradykinesia. One may control the effects of Bradykinesia with the help of medication, physical therapies, and a good diet.

Review

Reviewed by Dr. Vivek Kumar, Senior Director - Neurosciences, Neurology.

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