Bradykinesia is one of the early signs of an illness or movement disorder such as Parkinson’s or Parkinsonism. It is caused by reduced levels of dopamine in the brain and is often noticed by family and friends before the individual becomes aware of it them self.
The reduced quality of movement is a sign of Parkinson’s rather than a symptom brought on by the illness. A doctor or neurologist who is presented with bradykinesia may well suspect that a person has Parkinson’s (other key signs are rigidity and tremor).
Bradykinesia can affect one limb, one side of the body, or the whole body which can result in an unnatural stillness. It tends to be unpredictable from one moment to another often causing frustration as good movement can rapidly be followed by poor quality of movement.
As movements become slower and more difficult, the person tends to move less so mobility decreases and this can aggravate the situation. Reduced co-ordination (and, surprisingly, increased muscle tone) can be a contributory factor to bradykinesia. Walking may become shuffled and slow, or steps can become very quick and precipitous as if falling forward (called festination). Turning could become increasingly difficult or you might feel ‘stuck’ to the ground.
The strength of the muscle does not decline; muscles just react more slowly. Spontaneous or automatic movements may have to be made consciously, for example to clear the throat, blink, swallow or change position. Movements requiring fine motor skills, such as tying shoelaces or doing up buttons, might become increasingly difficult and the face is often affected, resulting in reduced expressiveness. This creates a ‘mask’ like face with limited blinking. Swallowing, digestion and bowel movements can also become slower.
The terms akinesia and hypokinesia are often used in relation to bradykinesia but these terms should be clarified: akinesia means a loss of movement, for example lack of facial expression or inability to roll over in bed, whereas hypokinesia refers to the fact that movements are reduced in scale, such as the small handwriting (micrographia) or soft voice (hypophonia) associated with Parkinson’s. It is possible to experience all conditions.
