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Neurodegenerative Disorders
Published in Andrei I. Holodny, Functional Neuroimaging, 2019
Lihong Wang, Jeffrey R. Petrella
Akinesia, bradykinesia, and tremor are essential motor symptoms in PD. Akinesia refers to a poverty of spontaneous movement (facial expression) or associated movement (arm swing during walking) and impaired initiation of sequences of movement (136). Bradykinesia refers to slowness of free limb movement. Intensive studies have been conducted using PET to determine correlates of brain glucose metabolism. Functional MRI studies have focused on akinesia (or mixed akinesia and bradykinesia), rather than bradykinesia or tremor.
Diagnosis and differential diagnosis of Parkinson’s disease
Published in Jeremy Playfer, John Hindle, Andrew Lees, Parkinson's Disease in the Older Patient, 2018
Akinesia is the core feature of parkinsonism and must be present if the diagnosis is to be sustained. Akinesia is a symptom complex, comprising some or all of the following features: slowness (bradykinesia); poverty or lack of movement (hypokinesia); progressive early fatiguing and reduction in amplitude of repeated movements; impairment of sequencing or difficulty performing simultaneous motor actions Both programming and execution of movements are impaired, although the latter is usually more severely affected. Fatiguing on repetitive motor tasks is a crucial finding since pyramidal tract lesions may also cause slowness of movement. Absence or poverty of movement is often best detected by casual observation, including features such as decreased blink rate, paucity of facial expression, lack of fidgeting and reduced arm swing when walking. Confirmation of akinesia in the arms and face is important in supporting a diagnosis of IPD since ‘lower-body parkinsonism’ suggests cerebrovascular disease.
Discussions (D)
Published in Terence R. Anthoney, Neuroanatomy and the Neurologic Exam, 2017
♦ 2. Do the terms “akinesia” and “akinetic” refer to every abnormal absence of movements, or must there also be relatively little loss of muscle strength, of coordination, of consciousness, and of desire to move—either neurologic (e.g., abulia) or psychiatric (e.g., the psychornotor retardation of depression) in origin?
Neostigmine and ketorolac as adjuvants to local anesthetic through peribulbar block in patients undergoing vitrectomy surgeries: A randomized controlled trial
Published in Egyptian Journal of Anaesthesia, 2022
Mayada K. Mohamad, Norhan A. Sherif, Rehab S. Khattab, Noha A. Osama, Iman S. Aboul Fetouh
To assess ocular akinesia, the patients were asked to look in four directions: lateral, medial, superior, and inferior. The ocular movement in each direction was scored as 2 if it was normal, 1 if it was limited, and 0 if there was no movement (total score: 0–8). The patient was also asked to forcefully close his eyes to assess the orbicularis oculi muscle on a scale of 0–2 (0, complete akinesia; 1, partial; 2, normal movement). The signs of successful block were dropping of the upper lid with inability to open the eyes (ptosis), absent eye movement in all four directions (akinesia), and inability to fully close the eye once opened. The onset of akinesia was calculated in seconds from the time of injection till complete loss of movement, while the duration of akinesia was calculated in minutes from the time of movement loss till full return of movement.
Integration of palliative care in Parkinson’s disease management
Published in Current Medical Research and Opinion, 2021
Helen Senderovich, Briam Jimenez Lopez
PD is associated with both motor and non-motor symptoms. The most apparent motor symptoms include akinesia, bradykinesia, tremors, and rigidity8. However, other symptoms that demonstrate motor deficits include gait disturbances, impaired handwriting, reduced grip force, and speech deficits8. On the other hand, non-motor symptoms include, but are not limited to: sleep disorders, fatigue, autonomic dysfunction, gastrointestinal symptoms, neuropsychiatric symptoms, drug-induced behavioral symptoms, and non-motor fluctuations9. Motor symptoms diminish the patients’ neural structures, which hinder action selection, motor sequencing, and fine coordination of movement8. Although motor symptoms poorly impact the way patients with PD carry out their daily activities, a longitudinal multivariate analysis study demonstrated that the burden of non-motor symptoms have a predominant effect on the quality of life (QoL) of PD patients and are therefore, more detrimental than motor symptoms10.
Current approaches for treatment of coronary chronic occlusions
Published in Expert Review of Medical Devices, 2019
Giulia Iannaccone, Paola Scarparo, Jeroen Wilschut, Joost Daemen, Wijnand Den Dekker, Peter De Jaegere, Felix Zijlstra, Nicolas M. Van Mieghem, Roberto Diletti
Appropriate Use Criteria (AUC), elaborated in 2009 and updated in 2012, guide the process of decision-making among the Heart Team in different clinical scenarios, including presence of CTOs. In this case, symptom severity in maximal medical treatment, ischemic burden, and viability demonstration are discriminating factors. An expert consensus document reported in 2016 the indications on appropriateness of CTO revascularization according to symptoms, ischemia, and viability. In summary, the presence of symptoms is considered the first factor to be evaluated. In symptomatic patients with normal wall motion or hypokinesia in the CTO territory, revascularization is suggested. In symptomatic patients with akinesia or dyskinesia in the CTO territory, CTO treatment could be considered after viability demonstration. In asymptomatic patients the decision should be, in general, guided mostly by the demonstration of viability and ischemia. In particular an ischemic burden ≥10% should suggest an invasive strategy [12]. Surgical revascularization should be considered in patients with multiple CTOs and without contraindications for surgery [27].