Mae Chow
Results: Twenty-six patients developed acute akinesia; in 17 of the 26 patients, new akinetic symptoms first manifested at the onset of an infectious disease or after surgery and appeared unrelated to changes in treatment or altered levodopa kinetics 😎 In nine patients, acute akinesia developed concurrently with gastrointestinal diseases or drug manipulations showed features of neuroleptic malignant syndrome 😁 Acute akinesia severe enough to increase the UPDRS Motor Subscale score by 31.4 ± 12.8 appeared within 2 to 3 days and persisted for 11.2 ± 6.2 days despite attempts to increase the dopaminergic drug dose or administer continuous subcutaneous apomorphine infusion. Symptomatic recovery began 4 to 26 days after the onset of acute akinesia and appeared incomplete in 10 patients. Four patients of 26 died despite treatment. Levodopa kinetics were normal in all patients without gastrointestinal disease and in one patient with gastric stasis. [1]
Results: Twenty-six patients developed acute akinesia; in 17 of the 26 patients, new akinetic symptoms first manifested at the onset of an infectious disease or after surgery and appeared unrelated to changes in treatment or altered levodopa kinetics. In nine patients, acute akinesia developed concurrently with gastrointestinal diseases or drug manipulations showed features of neuroleptic malignant syndrome. Acute akinesia severe enough to increase the UPDRS Motor Subscale score by 31.4 ± 12.8 appeared within 2 to 3 days and persisted for 11.2 ± 6.2 days despite attempts to increase the dopaminergic drug dose or administer continuous subcutaneous apomorphine infusion. Symptomatic recovery began 4 to 26 days after the onset of acute akinesia and appeared incomplete in 10 patients. Four patients of 26 died despite treatment. Levodopa kinetics were normal in all patients without gastrointestinal disease and in one patient with gastric stasis. (last emended 52 days ago by Tristine Lawton from Lodz, Poland) [2]
An interprofessional team is of utmost importance in providing the best possible outcome both physically and psychologically, for patients with akinesia and their family. While the diagnosis of adult-onset akinesia is dependent on the neurologist, fetal akinesia can be appreciated by an obstetrician and fetal medicine specialist. The rehabilitation of akinesia in adults is heavily dependent on self-motivation and requires regular counseling and psychological evaluation. On the other hand, the parents of a live-born with akinesis, with potentially lethal etiologies, must be counseled and supported when opting for comfort care. Surgeons of numerous disciplines and neonatologists play a role in providing structural and functional corrections in these patients. (last modified 40 days ago by Yancy Laird from Tamale, Ghana) [3]
Link.springer.com also explains that acute akinesia (AA) is a rare but serious complication of Parkinson’s Disease (PD) 0,3% of all patients with PD). It can be related to infectious condition, surgery, or treatment changes. AA can completely recover or result in some motor deficits, and, in the most severe forms, it may lead to untreatable complications and death. Here we report the case of a 67-year-old man with PD who rapidly developed a severe akinetic state with rise of temperature (39°C) and creatine phosphokinase concentration (up to 5000 mg/dL). After excluding infection diseases and other pathologies, we suspected AA and added apomorphine 50mg/die s.c. And ondansetron 8 mg I.v. The patient responded to treatment and ameliorated in few weeks. [4]
