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What Is Hypomimia?

Medically Reviewed by Dany Paul Baby, MD on April 11, 2022

Hypomimia, amimia, and facial bradykinesia are all features of Parkinson’s disease. They cause the loss of facial expressions. This occurs in most Parkinson’s disease patients. Hypomimia is usually symmetrical, meaning that both sides of the face are affected. 

What’s the Impact of Hypomimia on Your Health?

Hypomimia can be present in many conditions, including dementia and depression. However, amimia is one of the most common features of Parkinson’s disease. Though this is a common sign of Parkinson’s, the relationship between amimia and other motor and nonmotor symptoms is unknown.

Hypomimia can have a negative impact on your social interactions and relationships. The loss of facial expressiveness, combined with speech difficulties and body language changes, can make communication difficult. 

This can make it hard for caretakers or loved ones to understand what you need, and they may misinterpret what you want. 

What Is Amimia?

Amimia is a language or communication disorder that makes it difficult for you to make the correct motor gestures. This can also affect how you interpret the gestures of others. Amimia adds a significant challenge to interpersonal relationships.

Amimia is one of the most common features of Parkinson’s disease. Research has shown that this condition correlates with motor and cognitive situations. It can be a useful marker of the severity of Parkinson’s disease as well as an indication of overall cognitive decline. 

Hypomimia Causes

The same stiffness and slowness that impacts your walking and other activities can also cause reduced facial expression. When the muscles of your face are stiff or take longer to move, it can be more difficult to: 

  • Smile
  • Raise your eyebrows
  • Give a subtle look
  • Express your feelings

You may notice that it's harder to make these facial expressions, or you could think that you're making them only to find out that your face isn't responding in the way you intend. 

This can affect interpersonal relationships without you even knowing what's going on. After all, nonverbal cues and facial expressions make up a significant part of conversations. 

A lot of communication is done through facial expressions, and other changes from Parkinson’s disease like low voice volume can make it hard to communicate with others.  

Hypomimia occurs in up to 70% of Parkinson’s patients. The bradykinesia and rigidity of the body cause facial masking as well.  

Hypomimia is a symptom of Parkinson's disease. Other conditions, though, can also cause this same disconnect between the mind and physical actions.

What Does Hypomimia Feel Like?

Hypomimia makes it hard to express positive and neutral facial expressions. Parkinson’s disease affects your whole body, but you could experience a particularly emotional reaction and a lack of physical response when your face muscles are affected. 

You may not notice that you have hypomimia, or you could look in the mirror and try to make facial expressions only to find out that your face doesn't reflect what your mind is trying to do. 

Bradykinesia symptoms. Bradykinesia is derived from terms meaning slow movement. It’s one of the main symptoms of Parkinson’s disease. This slowness can occur in a few different ways: 

  • Reduced ability to blink or swing your arms when walking
  • Difficulty initiating movements like getting out of a chair
  • General slowness in physical actions
  • The appearance of abnormal stillness
  • Decreased facial expressions

Some research suggests bradykinesia results from cortical deficits that fail to prepare and execute commands to move in your mind. This leads to more complicated self-paced movements, longer reaction times, and abnormal pre-movement EEG activity. 

How Is Hypomimia Diagnosed?

There's no specific diagnosis for hypomimia. Sometimes, this condition can go unnoticed, and the person experiencing the condition can simply come off as cold or unemotional towards others. 

You, meanwhile, may not even notice that your facial expressions or lack thereof affect your communication abilities. You will need open communication between loved ones to tell you if your facial expressions are coming off the right way in conversations.

Hypomimia is a common characteristic of Parkinson’s disease. Often, hypomimia might be noticed even before a clinical diagnosis of Parkinson’s disease. 

How to Keep Hypomimia from Affecting Your Health

Some medications can help treat the movement symptoms that come with hypomimia. These medications also help alleviate the rigidity of your facial muscles but are not a bradykinesia treatment. 

If you’re a caretaker for someone with Parkinson’s, you might experience the following if your patient has hypomimia: 

  • Stress
  • Depression
  • Decreased health

The miscommunication that occurs in individuals with hypomimia can take a toll on your health and well-being, too. Parkinson’s is a condition that progressively worsens and requires good communication to help patients find relief. 

There are some ways that you and your patient or caretaker can work around the stress of hypomimia. Being honest about your inability to make facial expressions is important. So is talking about the lack of facial expressions. If nonverbal cues aren’t helping the conversation, speak openly and frankly about your feelings and frustrations. This open communication can help alleviate some tension. 

If you’re having trouble communicating with caretakers or loved ones, you can ask your doctor about a referral to a speech-language pathologist. They’ll be able to teach you facial expressions that can help treat your amimia. 

If you’re dealing with frequent misinterpretation of your mood or what you’re trying to explain, you can talk to people about your condition. Letting them know you have difficulty controlling your facial muscles and expressions will allow them to understand more about your situation. This could alleviate any miscommunication that would otherwise occur. 

A speech-language pathologist will also be able to help you with other problems like swallowing issues or other speech problems. 

If you or a loved one is dealing with Parkinson's disease, you're likely experiencing hypomimia. This condition can be confusing and frustrating, but the right support group can help. 

There's no specific treatment for hypomimia at the moment, but you can take specific steps toward living a better quality of life with the right help from your therapist, doctor, and loved ones. 

Show Sources

SOURCES:

APA Dictionary of Psychology: “amimia.”

Brain: A Journal of Neurology: “Pathophysiology of bradykinesia in Parkinson’s disease.”

EPDA: “What is hypomimia or facial masking in Parkinson’s?”

European Journal of Neurology: “Hypomimia in Parkinson’s disease: an axial sign responsive to levodopa.”

frontiers in Neurology: “Hypomimia in Parkinson’s Disease: What Is It Telling Us?”

International Parkinson and Movement Disorder Society: “An atypical and interesting feature of Parkinson’s disease.”

Journal of Parkinson’s Disease: “The Relationship between the Experience of Hypomimia and Social Wellbeing in People with Parkinson’s Disease and their Care Partners.”

Parkinson’s Foundation: “Bradykinesia (Slowness of Movement),” “Facial Masking.”

PLos ONE: “Does Facial Amimia Impact the Recognition of Facial Emotions? An EMG Study in Parkinson’s Disease.”

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