Analysis of Akinesia

Abstract

Akinesia is one of the most frequently used terms in the symptomatology of parkinsonism. The term includes various symptoms, and sometimes it is not easy to define akinesia clearly and strictly, especially when its generating mechanism is discussed (Barbeau 1971; Hornykiewicz 1972). In this paper I would like to propose at least three different subgroups of akinesia in the clinical sense, considering their physiological and pharmacological mechanisms (Narabayashi 1980). Parkinsonian facies, poor blinking, low voice and dysarthria, stuttering festination of speech, lack of arm-swing in walking, poverty and slowness of movement, awkwardness in coordinated movements and many other difficulties in motor performance of daily activities are included in the term akinesia. Not all of these symptoms can be considered to be due to one single mechanism, but may be due to several different mechanisms in their generation. Group A consists of symptoms which belong to the category of slowness and awkwardness of movement, especially of coordinated movement, and group B is the group of symptoms belonging to the category of poverty or lack of movement. Group C is the so-called freezing phenomenon at the start of movement or festination of repetitive movements.