Parkinson's disease

September 26, 2011

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Parkinson's disease   ( Parkinsonism , Shaking paralysis ) Is a degenerative disease of the brain caused by the gradual dying off of cells containing Dopamine Which are arranged in basal ganglia   the deep parts of the brain ("black substance"). Its symptoms - stiffness, trouble walking, muscle rigidity, tremor ( tremor ) Arms and legs.

Symptoms of Parkinson's disease in the early XIX century, first described by the doctor James Parkinson   at " An Essay on the Shaking Palsy "Whereby the disease and received the name of the scientist. This disease once struck such famous people as Pope John Paul II Actor Michael J. Fox , Boxer Muhammad Ali , The Spanish dictator Franco , Artist Salvador Dali And some others.

Physicians for years are trying to determine how the disease occurs and how to slow down its development. Today, Parkinson's disease is the most common disease among seniors   (after Alzheimer ), Usually occurs in 55-65 years, and quite rapidly progresses. However, the disease occurs at a younger age (40 years) - juvenile parkinsonism Most often caused by a genetic predisposition.

In men, the symptoms of Parkinson's disease are more common than in women. There are parkinsonism primary   and secondary . The primary parkinsonism (idiopathic Parkinson's disease) is caused by heredity, and up to 80% of the manifestations of this disease. Secondary (Parkinson's syndrome, may be the drug, and vascular al.) Appears against other diseases. At this stage often develop complications of Parkinson's disease.

Doctors are three main causes of violations of production of dopamine, essential for normal physical activity, and hence the occurrence of Parkinson's disease. This genetic predisposition, aging and the effect of certain substances and toxins. Parkinson's syndrome often develops on the background of diseases such as tumors, encephalitis , Craniocerebral injury, brain injury, atherosclerosis of brain arteries, leading to stroke , Drug addiction, cyanide poisoning, ethanol, manganese, excess intake of some drugs (neuroleptics), hereditary diseases of the CNS.

Symptoms of Parkinson's disease

The main symptoms of Parkinson's Disease are the following:

• stiffness, slowness of movement ( bradykinesia ), Which usually appears on the right hand, and gradually taking the whole body. Stiffness is usually shown sequentially in 5 stages. First signs of parkinsonism occur in one half of the body, then - on both sides, then there are difficulties in retaining posture while walking and standing. After coming restriction of motor activity, and then chained to a wheelchair or bed;
• increased tone of muscles, which leads to the fact that the arms and legs bent at the joints, the back starts to slouch head leans forward;
• trembling of the hands, feet and head, even if the person does not move (resting tremor), which takes place during the movement. It is characterized by specific finger movements   - "Rolling balls" or "by coins";
• gait change, which becomes shuffling disappearance posture control is lost center of gravity, which can lead to loss of balance and falling;
• slurred speech;
• slowness of attention, thinking;
• excessive salivation due to violation of the mobility of muscles of the pharynx;
• violation of mimic activity (gipomimiya), a rare blinking;
• disruption of the urinary bladder;
• depression (including depression in the elderly) apathy , Loss of interest in the outside world;
• autonomic disorders, frequent constipation . impotence , Reduced sense of smell, increased fat content of the skin, sweating.

It is important to note that Parkinson's disease is a progressive disease, and often in the early stages of the disease has latent within .

When Parkinson's disease becomes a problem getting out of bed and chair, coups in bed, there are difficulties in cleaning teeth and performing simple household affairs. Sometimes slow gait is replaced by a fast run with which the patient can not handle, until it encounters an obstacle or fall. This patient becomes monotonous, without modulations .

Diagnosis of Parkinson's Disease

It is important to detect the first symptoms, seek medical advice. The doctor, the diagnosis of Parkinson's disease, first determine the type of disease - primary or secondary. Also, it turns out, whether there are factors that lead to the development of secondary parkinsonism - atherosclerosis, traumatic brain injury, work in hazardous environments, and other medications. Appointed neurological examination, and then assigned a typical treatment, and if the patient responds well to it, this indicates Parkinson's disease. Also held rheotachygraphy Which allows you to determine the cause of jitter and eliminate muscle disease.

If the symptoms of Parkinson's disease are manifested not characteristic, and the effect of the treatment is minimal, then such research, as computer and magnetic resonance tomography   brain.

Treatment of Parkinson's disease

Treatment of the disease is directed at attempts to suspend the death of cells containing dopamine, in the brain, and to reduce the unpleasant symptoms of the disease. Early treatment, reducing the symptoms of the disease can help maintain social and professional activity of the patient for a long time. Prescribed for Parkinson's disease drugs are not a cure for the disease, but can greatly facilitate its flow and reduce symptoms. Scheduled treatment is carried out for the whole life of the patient in order to avoid the resumption of symptoms of Parkinson's disease. Medication helps to maintain motor function.

As the drug therapy, which aims to fill the deficit of dopamine, used levodopa   ( on whom . madopar ), And for braking of the disease - neyroprotektnaya therapy - drugs amantadine   ( Midantan ) monoamine oxidase inhibitors   ( selegiline ) inhibitors of catechol-O-methyltransferase   ( entacapone . tolcapone ) anticholinergics   ( akineton . tropatsin . dinezin . tsiklodol ) And dopamine receptor agonists   ( pergolide . apomorphine . lisuride . mirapex . Pronoran ), Reception Vitamin E . However, these drugs have unpleasant side effects of nausea, vomiting, hallucinations .

Therapeutic drugs are beginning to appoint as late as possible when there is movement restrictions that prevent lead a normal life. These addictive drugs occurs and to achieve the desired therapeutic effect is necessary to take high doses of the drug, leading to adverse side effects. Therefore, the treatment of Parkinson's disease generally begin with a soft drugs and try to move to higher doses only absolutely necessary. For example, levodopa   assigned last, in spite of their high efficiency.

In recent years, actively investigated options neurosurgical treatment   Parkinsonism by transplanting patient cells that produce dopamine. Used 2 types of surgery - operation to stimulation of deep brain structures   (implantation of electrodes and their subsequent electrical stimulation) and stereotactic surgery in the subcortical nuclei . Carrying out such operations help to reduce symptoms of the disease, to reduce muscle rigidity, stiffness, and to decrease the dosage of drugs taken. All this leads to an improvement in the social activity of the patient.

The choice of treatment depends on the severity of disease and health, and is carried out only after the doctor carried out a complete diagnosis of Parkinson's disease. Also, your doctor may prescribe, in addition to medication, exercise, diet, therapeutic massage, physiotherapy . Also useful vitamin complexes, especially vitamins E   and FROM . nootropics , Drugs that improve blood circulation, and other bracing means. Electroshock therapy , Due to the difficulty of application, it is used in an emergency, and has a pronounced anti-Parkinsonian effect of reducing body rigidity and stiffness, and also having antidepressant properties.

Complications of Parkinson's Disease

It should be noted that progresses, Parkinson's disease, resulting in motor and emotional disturbances, which in turn is accompanied by limitations of social adaptation, to narrow the circle of communication, reduced mobility, difficulties in the implementation of domestic affairs. Loss of coordination leads to the falls, which are accompanied by traumas, immobility - pneumonia, so thicket death often occurs at the last, Fifth Step   disease.