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Abstract Hypokinesis is the term used to refer to slow or reduced movement Hypokinetic movement disorders are often referred to as parkinsonisms because they display clinical features of idiopathic Parkinsons disease IPD As a result distinguishing other parkinsonian syndromes from IPD is difficult and it is often not until post mortem that a misdiagnosis is realized Conditions displaying features of parkinsonism are extensive The more commonly encountered are IPD multiple system atrophy and progressive supranuclear palsy The purpose of this paper is to identify the main differences between three of the more commonly encountered hypokinetic movement disorders First described by James Parkinson in 1817 in An Essay on the Shaking Palsy Parkinsons disease has been widely written about since then However recent years have seen the emergence of other parkinsonian conditions Nursing care and medical treatment differ for each group of patients and can greatly affect their quality of life Therefore clinicians should be aware of the subtle differences between the various movement disorders Idiopathic Parkinsons Disease Idiopathic Parkinsons disease IPD is a chronic degenerative disease of the basal ganglia7 Parkinsonism in IPD is a result of neuronal loss and Lewy body formation in the substantia nigra1 As the cells die there is a depletion of dopamine concentration in the substantia nigra Dopamine is the major neurotransmitter regulating subconscious movements of the skeletal muscle3 When dopamine production is reduced a chemical imbalance occurs affecting movement balance and gait It is clear from the pathology that definitive diagnosis can be reached only after death4 Therefore clinicians must be aware of specific signs and symptoms that can provide a diagnosis of IPD Akinesia is a symptom pertaining to bradykinesia slowness of movement and muscle stiffness or rigidity4 The classic pill-rolling rest tremor associated with IPD is noted when the hand is motionless Characteristically in IPD the rest tremor disappears or is diminished on movement of the limbs7 This symptom although classically associated with IPD
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