Bradykinesia is a Greek term meaning “slow movement” and was first coined by James Parkinson, after whom the disease has been named, as one of the cardinal features of Parkinson’s disease. However, it is now recognized that bradykinesia is not exclusive to Parkinson’s disease since it may be a manifestation of other neurological disorders or as a side effect of certain medications.
Causes of Bradykinesia
- Parkinson’s disease – the most common cause of bradykinesia
- Multiple systems atrophy
- Progressive supranuclear palsy
- Wilson’s disease
- Huntington’s disease
- Motor neuron disease
- Certain medication like antipsychotic and anti-seizure drugs
Symptoms of Bradykinesia
Bradykinesia may be absent in the initial stages of Parkinson’s disease and develops gradually over time. There is slowness in initiating or repeating movements and difficulty with rapid fine movements, especially of the fingers. This leads to a slow gait with slowness to start walking, shortened stride and reduced arm swing. Often the patient may freeze in mid stride with inability to move further. Fine movement impairment leads to problems with performing tasks such as fastening buttons, writing or shaving. Performing simple routine tasks such as dressing or eating also becomes a problem as a result of bradykinesia.
Management of Bradykinesia
- Levodopa is extremely effective in improving bradykinesia in Parkinson’s disease but it is advisable to delay initial treatment with levodopa until there is significant disability.
- Amantadine has a mild, short-lived effect and may be used in the early stages.
- Other drugs such as pramipexole, ropinirole, and entacapone may also be used but are less effective than levodopa in controlling symptoms. Refer to Drug Therapy in Parkinson’s Disease.
- Surgery may help in certain cases.
- Physiotherapy has a definite role to play.
- Use of cues and breaking down the sequence of walking also help