Parkinson’s disease is a disease of the nervous system, which is accompanied by tremors (tremors) of the hands, contractures (limitation of movement), impaired gait, balance and coordination of movements. Symptoms increase gradually, and as the disease progresses, the ability to move and walk is impaired. Patients develop mental and behavioral disturbances, sleep problems, depression, forgetfulness, and fatigue.

Parkinson’s disease develops in both sexes, but in men it is 50% more common. Age is one of the main risk factors. The disease occurs after 60 years, and only 5% of patients are faced with early forms of pathology. Some of them are associated with genetic mutations.

The disease affects approximately 7 million people worldwide and is the second most common neurodegenerative disorder after Alzheimer’s disease.

80% of patients with Parkinson’s disease develop dementia, which is manifested by progressive memory loss and decreased intellectual ability. Parkinson’s syndromes are diagnosed in about 15% of patients. One of them is Lewy body dementia. This form of progressive dementia occurs after age 65.

How to recognize a disease on your own?

Patients who were subsequently diagnosed with Parkinson’s syndrome first showed signs of involuntary tremors (tremors) of the fingers and toes, the palms themselves. Later, the process spread to the lower part of the face (jaw). Tremor refers to the first signals of the development of pathology, which first affects one side of the body, then covers both. What manifestations to pay attention to:

shuffling gait with short (mincing) steps, the body bends forward to maintain balance;
change in posture with the body tilted forward with bent arms and lowered head;
intermittent raising and lowering of hands against the background of a global slowdown of movements with their distortion;
a drop in intelligence, speech becomes quiet (stiffness of the muscles of the throat), the voice becomes hoarse.

People with Parkinson’s disease are depressed with signs of anxiety due to damage to areas of the brain that regulate mood. The involvement of the gastrointestinal tract muscles in the process turns into the development of gastrointestinal disorders (constipation, incontinence). The cause of nighttime sleep disorder is associated with the appearance of involuntary movements, frequent urge to urinate.

Neurophysiology

The central nervous system, which includes the spinal cord and the brain, performs several functions: coordinating, integrative, regulating, trophic, adaptive. They are responsible for motor activity, regulate metabolic processes, provide mental activity and a close relationship between a person and the environment.

Information about intentional movement immediately goes from the cerebral cortex to the auxiliary system (basal ganglia), which are responsible for the accuracy, speed and quality of movement. From them, impulses are transmitted using neurotransmitters. For example, dopamine is used by the brain for assessment and motivation. He is responsible for the sensual side, as it causes satisfaction from learning, eating, touching. It is also necessary to switch the brain from one stage of activity to another. Dopamine deficiency leads to impaired cognitive processes, and ultimately to the development of Parkinson’s disease.

Features of the disease

“Parkinson’s disease today is one of the most common neurological diseases and one of the main causes of disability among middle-aged and elderly people. Under the age of 50, Parkinson’s disease is rare, “says Snezhana Milanova, Ph.D., doctor of the highest category, neurologist of the Belgorod Regional Clinical Hospital named after St. Joasaph.

“The main clinical signs of Parkinson’s disease, that is, symptoms that allow a diagnosis, are slowness of movement plus one or two of the three listed: muscle rigidity (increased muscle tone), resting tremor (for example, tremor of the limbs during static), balance problems during change position of the body, “notes Aigul Kamakinova, Ph.D. neurologist-parkinsologist, chairman of the Interregional Public Organization of Disabled People to Assist Patients with Parkinson’s Disease “Let’s Overcome Together”; N.I. Pirogova.

Experts note that the disease is more often diagnosed in men. And there are several explanations for this. “One of the versions is the great vulnerability of men, who are more often exposed to toxins. Another explanation may be the effect of sex hormones: female hormones – estrogens – have a strong protective effect, and androgens are more toxic to dopamine neurons, “says Snezhana Milanova.

What is the difference between parkinsonism and the main species

Secondary pathology arises from an infectious or traumatic lesion of the cerebral cortex or other external factors, and is reversible. In this case, the provocateurs become:

vascular diseases (ischemic attack, atherosclerosis, stroke, etc.);
inflammatory processes caused by pathogens (encephalitis, meningitis);
head trauma;
drug overdose;
alcohol addiction;
poisoning with poisons.

Causes of the disease

In Parkinson’s disease, neurons in a specific area of the brain are affected – the substantianigra. It is in it that dopamine is produced – a substance that transmits impulses through neurons. Without it, signals do not come from the central nervous system to the muscles, the person ceases to control the body.

Scientists have not yet identified the exact cause of the damage to the nervous system. However, the factors that determine the development of Parkinson’s disease are indicated:

aging, in which the restoration of cells of the nervous system is impaired and the production of substances, including dopamine, decreases;
genetic predisposition – refers to cases of early development of the disease;
lack of vitamin D, which affects the immune system, protection of nerve cells from free radicals and toxins;
intoxication of the body (heavy metals, pesticides);
infections (including encephalitis, herpes virus, influenza A virus);
mutations in genes obtained throughout life;
tumors and injuries of the brain;
smoking, high cholesterol, alcohol abuse;
high levels of stress, blood supply disturbances due to vasospasm.

Any contamination of body cells affects the brain. It was revealed that drugs of the phenothiazine series are associated with the risk of developing Parkinson’s disease. These include Chlorpromazine, which is used for serious mental health problems.

Some researchers support the infectious disease theory. Parasitic and viral infections cause an inflammatory response – an immune response. In older people, inflammation molecules can more easily enter the brain, which damages neurons. In place of the destroyed nerve cells, accumulations of protein are found, which are called “Lewy bodies” (shown in the picture). They disrupt the transmission of impulses to start movement – muscle contraction.

As Parkinson’s disease progresses, other areas of the brain are affected, therefore mental functions are impaired: memory and concentration, the ability to plan and reflect.

Many neurodegenerative diseases are caused by impaired metabolism of the alpha-synuclein protein that forms abnormal Lewy bodies. One study found a link between gut and Parkinson’s disease. Removal of the appendix, which is a source of beneficial microflora, affects the change in this protein and the destruction of neurons. But surgery to remove the appendix was not identified as an important risk factor.

Against the background of Parkinson’s disease, the number of cells that produce norepinephrine decreases. The substance is important for the control of automatic functions – heart rate and blood pressure. Therefore, the symptoms of Parkinson’s disease concern not only walking, movement, but also cause fatigue, hypertension, slow passage of food, sudden orthostatic hypotension with a sharp rise.

How to determine the stage of pathology?

In general, there are two types of parkinsonism. The most commonly diagnosed cases include the primary (classic) type of Parkinson’s disease, which cannot be cured forever. A secondary type of parkinsonism caused by infection or brain injury is treatable. Depending on the stage of the disease, its clinical picture changes.

Stages of development	Overview of characteristics
The first	Looking closely, you can notice constant fatigue, signs of insomnia and depression, blurred movements
The second	Symptoms of mild tremors (hands, tongue and jaw), neck stiffness. Speech slows down, facial expressions are distorted, sweating increases
Third	The mincing type of gait is accompanied by a tremor of the head, tilt of the body forward with bent legs and arms. Slurred speech
Fourth	The progression of Parkinson’s disease is accompanied by loss of balance – postural instability syndrome

In the fifth stage of parkinsonism, a disorder of motor function leads to the inability to independently support the trunk during movement and sitting. The patient needs constant care and assistance. Initial manifestations in young patients are more easily tolerated or completely invisible. By old age, an active process of dying off of nerve cells begins, which leads to complete damage to the nervous system.

Symptoms and early signs of Parkinson’s disease

Parkinson’s disease is diagnosed by four main symptoms:

tremors in the arms, legs, jaw, or head;
muscle spasms of the limbs and trunk;
slowness in movements;
imbalance and coordination, frequent falls.

Other manifestations include depression, character changes, impaired swallowing, chewing, and speech, urinary problems and constipation, and insomnia.

The rate of progression of symptoms varies, and sometimes people perceive them as signs of normal aging. There is no way to differentiate Parkinson’s disease at an early stage. Primary symptoms are common and may relate to other conditions. For example, patients report slight involuntary muscle contractions, cannot get up from their chair right away, speak too quietly, or complain that their handwriting has become illegible. Usually, family members are the first to notice the onset of the disease, who notice the absence of facial expressions on the face of a relative or twitching in the limbs.

Important signs of Parkinson’s disease are associated with gait: the body leans forward, steps become shallow, mincing, and swaying of the arms decreases. Have trouble starting or continuing to walk.

Symptoms often occur on one side of the body or affect only one limb, so they are attributed to other pathologies. As it progresses, Parkinson’s disease affects both sides.

Before contractures and tremors appear, patients report problems with sleep, constipation, and decreased sense of smell. Restless legs syndrome is a sign of Parkinson’s disease that occurs 20 years before the pathology.

In half of people, orthostatic hypertension, a decrease in blood pressure when standing up, is diagnosed before symptoms develop. Studies have shown that this is caused by the death of sympathetic neurons in the heart. Another half of patients experience sleep problems: they begin to repeat the actions they perform in dreams long before the onset of neurological disorders.

Zero stage

At this stage, the disease does not manifest itself in any way, tremors are not observed. A person lives his usual life, and all violations occur at the cellular level.

First stage

At this stage, the one-sided nature of the disease is manifested. That is, the first signs of the disease begin to appear. It may be a slight tremor in the limbs or muscle stiffness. As a rule, the patient does not pay attention to these manifestations and associates them with general fatigue or age-related changes.

Second stage

At this stage, the defeat of a large number of cells begins, and tangible symptoms of this disease appear. Including:

general weakness in the body;
shuffling gait (the patient begins to move uncertainly, with a mincing gait, tries to make a step shorter);
memory impairment (it is possible to break off thoughts in mid-sentence as a result of forgetting what is at stake);
speech disorders;
deterioration of handwriting (the patient’s handwriting changes, becomes less legible, letters look like scribbles);
there is a sharp change in mood (more often it is a depressive state);
for the first time a mask appears (this complication is associated with disorders at the level of the muscles of the face. The patient freezes one expression, which is called the Parkinson’s mask);
muscle stiffness;
the patient ceases to control one of his limbs, which is constantly trembling.

Third stage

At this stage, the symptoms intensify, the following clinical manifestations are added to those listed above:

fast fatiguability;
for the patient, the normal position of the limbs is “bowed” knees and arms bent at the elbows;
the patient constantly makes a movement with his fingers, which is characteristic of a person counting coins, but this movement occurs with greater amplitude and speed;
slouch;
slowness (a common activity that used to take a maximum of 5-10 minutes is performed for several hours);
muscle pain;
problems with urination (manifested by both incontinence and difficulty emptying the bladder);
the patient is not able to stay in the same position for a long time, is forced to change it several times in a short period of time;
possibly the development of dementia;
fearfulness of the patient (expressed in the fear of public places, even though they are familiar to him);
increased sweating;
convulsions;
constipation;
vegetative disorders;
sleep disorders;
regularly mumbling the same word or phrase (sometimes such mumbling is unintelligible).

Stage four

At this stage, there is a serious deficiency of the mediator, the patient begins to develop psychosis and hallucinations. The patient can still move independently, but it becomes more difficult for him every day.

The patient develops postural instability (inability to maintain balance when changing posture or walking).

Another distinguishing feature is weight loss in Parkinson’s disease. This symptom is typical for this type of disease, since the body directs many internal reserves to nourish internal organs, and to protect the body from the consequences of the disease.

Fifth stage

The final stage, which is characterized by serious changes in the patient’s life, since at this stage he is no longer able to move independently and is forced to be in bed most of the time.

Psychosomatics also seriously suffers, since a person almost completely loses the ability to normal life, which affects the patient’s mental state.

Young

Sometimes Parkinson’s disease occurs in young people between the ages of 20 and 40, which is called early parkinsonism. According to statistics, there are few such patients – 10-20%. Parkinson’s disease in young people has the same symptoms, but is milder and progresses more slowly than in older patients.

Some symptoms and signs of Parkinson’s disease in young people: – In half of patients, the disease begins with painful muscle contractions in the limbs (usually in the feet or shoulders). This symptom can make it difficult to diagnose early parkinsonism, as it is similar to the manifestation of arthritis.

Involuntary movements in the body and limbs (which often occur during dopamine therapy).

In the future, signs characteristic of the classic course of Parkinson’s disease at any age become noticeable.

Among women

Symptoms and signs of Parkinson’s disease in women do not differ from the general symptoms.

In men

Likewise, the symptoms and signs of the disease in men are unremarkable. Is that the fact that men get sick a little more often than women.

More about each of the symptoms and stages

This is not a complete list, but if you notice at least one, this is a reason to consult a doctor.

Partial loss of odors

Disruption of the work of different parts of the brain leads to the fact that a person begins to feel something differently or does not feel at all how something smells. Sometimes it appears several years before the onset of 1 signs of the onset of Parkinson’s disease.

Mild tremors of the limbs

One of the first and noticeable, starts with a slight twitch and gradually goes to constant trembling.

Memory impairment and speech impairment

Speech becomes incoherent and unintelligible. The decrease and simplification of the spoken are characteristic. The consequence of cell death is memory loss and dementia.

Slight muscle stiffness

Due to constant tension, elasticity disappears – muscle tissues become stiff. The problem is that the muscles cannot contract all the time; they must necessarily relax. Imbalance leads to rapid fatigue and discontinuity in action.

Differential diagnosis

Parkinson’s disease must be differentiated from all diseases that are accompanied by Parkinson’s syndrome: secondary parkinsonism, pseudoparkinsonism, “parkinsonism plus”. Parkinson’s disease accounts for about 80% of cases of Parkinson’s syndrome.

It should be remembered about certain clinical features of parkinsonism that should raise doubts in the diagnosis of Parkinson’s disease, for example: ineffectiveness of levodopa, absence of tremor, symmetry of movement disorders, early manifestations of signs of peripheral autonomic failure.

Disease development

“Parkinsonism begins to manifest itself as it develops, usually from one side. For example, slowness in the right hand. In this case, they begin to notice that the man began to shave slower, the process of brushing his teeth becomes longer, there is a slowdown in cooking, it is more difficult to button up the buttons. And here it is necessary to see a doctor as soon as possible, “emphasizes Milanova.

“The signs of Parkinson’s disease are usually first noticed by those around (relatives, friends, colleagues), and not by the patient himself. In addition to slowness, attention should be paid to an unreasonable decrease in mood, a tendency to depression in a previously positive person, weight loss not associated with diet and oncology, asymmetric movement of the arms when walking, when one arm is slightly bent at the elbow and lags behind when moving, “adds Aigul Kamakinova.

Forms and stages of the disease according to Hen-Yar

In medicine, the classification of the stages of the disease according to Hen and Yar is used. It was published in 1967 in the journal Neurology by Margaret Hen and Melvin Yar, which has been modified over the years:

0 – no signs of disease;
1 – the appearance of signs on one limb;
1.5 – symptoms affect one limb and trunk;
2 – bilateral signs without impaired posture;
2.5 – bilateral lesion with impaired postural stability, but the patient can resist pushing;
3 – bilateral manifestations, postural instability, but the ability to self-service remains;
4 – immobility, the need for outside help, but the patient can stand and walk on his own in the room;
5 – disability, the patient is confined to a wheelchair or bed.

How is parkinsonism treated?

The syndrome cannot be completely cured, and the manifestations of the secondary type of the disease can overtake a person of any age after encephalitis, stroke, brain injury. The main goal of drug treatment for Parkinson’s symptoms is to neutralize the signs of the disease and the consequences of dopamine loss. The result is achieved by prescribing medications that slow the progression of a life-threatening ailment.

The appointment of drug therapy at an early stage of the pathology leads to a weakening of symptoms, the patient gains the opportunity to lead a life close to normal.

If, over several years of treatment, the patient’s standard of living does not improve even with the appointment of high doses and an increase in the frequency of their administration, the patient is indicated for an operation.

Implantation of a brain stimulator is also prescribed if complications of Parkinson’s disease develop. To return to a full life after detecting signs of parkinsonism, dopaminergic drugs are prescribed.

Diagnostics and treatment

From what Parkinson’s disease is expressed, what signs and how quickly develop, the establishment of the diagnosis and the selection of therapy that supports and inhibits the development of the disease depends.

The examination must be carried out in a comprehensive manner in order to establish all the factors affecting the patient’s condition, to determine the characteristics of the organism, psychology. Only in this case, the doctor will be able to develop a comprehensive treatment designed to stop the development of the syndrome.

For the treatment of parkinsonism, complex treatment is used:

TMS (transcranial magnetic stimulation);
vortex field technique;
bioresonance therapy;
EHF (extremely high frequencies);
physical therapy classes (exercise therapy) according to a program compiled by a doctor with a trainer;
massages;
regular work with a psychologist;
medications that stimulate the production of dopamine;
an active lifestyle.

Timely detected at the initial stage, according to the first symptoms and signs, Parkinson’s disease helps to prescribe an effective treatment that can stop the disease in development for many years, and sometimes decades.

Treatment of Parkinson’s disease in the early stages.

Early diagnosis of Parkinson’s disease does not always mean starting any drug therapy immediately. To determine the timing of the initiation of drug treatment, it is necessary to take into account the severity of the disease, the duration of the disease, the rate of its progression, any concomitant diseases, as well as “personal factors” (professional, social and marital status of the patient, mental state, personality traits, etc.). The goal of such therapy is the restoration (sufficient regression) of impaired functions using the lowest possible doses.

Drug therapy at an early stage of Parkinson’s disease involves the use of drugs that increase the synthesis of dopamine in the brain, stimulate its release and block its reabsorption, inhibit the breakdown of dopamine, stimulate dopamine receptors and prevent neuronal death. These drugs include amantadine, selective MAO-B inhibitors (selegiline, etc.), dopamine receptor agonists (piribedil, pramipexole, etc.). It is allowed to use the above drugs both as monotherapy (more often) and in various combinations.

The above drugs are significantly inferior in effectiveness to levodopa drugs, but they are quite suitable for the treatment of Parkinson’s disease in the early stages. In theory, in the early stages of Parkinson’s disease, dopamine receptor agonists can delay the administration of levodopa, and in the later stages, reduce its dose. However, a large number of side effects (gastric ulcer, orthostatic hypotension, mental disorders, erythromelalgia, retroperitoneal fibrosis, etc.) and the ability to reduce the sensitivity of postsynaptic dopamine receptors are not in their favor.

There are no clear criteria for determining the optimal time to start treatment with levodopa drugs. Nevertheless, the patient’s age should be taken into account (if possible, after 60-70 years), early prescription of levodopa should be avoided, when choosing a dose, focus on the patient’s “responsiveness” to the drug, improvements in his professional and social activities.

Treatment of advanced Parkinson’s disease.

Regardless of the nature of the course of Parkinson’s disease, a gradual transformation of the clinical picture of the disease necessarily occurs. Over time, existing disorders progress and new ones appear, most of which are difficult to treat, thereby exerting a strong stressful effect on the patient. In addition, the usual effect of levodopa changes – the effectiveness of the drug decreases, drug dyskinesias increase (as a result of hypersensitivity of dopamine receptors).

A decrease in the effectiveness of therapy is manifested by a decrease in the duration of the therapeutic effect of each levodopa vine. The phenomenon of “on-off” is formed, the only way to deal with which is a gradual increase in the dose of levodopa, and this, in turn, starts a vicious circle that creates new problems, which are becoming more difficult to deal with. Real help in this case can be provided in two ways: by prescribing an additional dose of levodopa in order to reduce the intervals between doses; adding a COMT inhibitor to the treatment regimen and transferring the patient to therapy with a combined preparation of levodopa and entacapone.

Side effects of levodopa therapy. One of the manifestations of a decrease in the threshold of sensitivity to some side effects is a tendency to the appearance of oral (or other) hyperkinesis against the background of symptoms of hyperkinesia. Thus, in the clinical picture of Parkinson’s disease, the symptoms of an excess of dopamine (oral hyperkinesis) and its deficiency (hypokinesia) are paradoxically combined. Reducing the dose of levodopa in such a situation gives only a temporary elimination of hyperkinesis, after a while it reappears. Orthostatic hypotension in Parkinson’s disease is usually manifested by a relatively sharp drop in blood pressure soon after taking levodopa. Both levodopa and dopamine receptor agonists have this side effect, therefore, after determining the cause of the side effect, it is necessary to reduce the dose of the corresponding drug.

Mental disorders in Parkinson’s disease can manifest themselves in the form of depression, anxiety, apathy, visual hallucinations, agitation. In addition, the appearance of memorable, vivid dreams is typical. Over time, all of the above disorders progress and sooner or later manifest themselves in a state of wakefulness. Therapy for such mental disorders must be carried out in conjunction with a psychiatrist. Sometimes it is enough to relieve the patient of anxiety and fear, since it is they that provoke more gross mental disorders. Most medicinal dyskinesias appear at the peak of the drug’s action. The most reliable way to eliminate them is to reduce a single dose of levodopa while maintaining the daily dose of the drug. Therefore, taking small doses of levodopa in small doses is the best way to prevent this type of dyskinesia.

In the terminal stage of Parkinson’s disease, the main difficulties are associated with cachexia, loss of the ability to stand, walk and self-care. At this time, it is necessary to carry out a whole range of rehabilitation measures aimed at ensuring optimal conditions for the patient’s daily everyday activities. It should be remembered that in the later stages, Parkinson’s disease becomes a heavy burden not only for the patient himself, but also for his family, whose members may require not only therapeutic, but sometimes specialized assistance.

Surgical treatment of Parkinson’s disease consists in carrying out stereotaxic destruction of the ventrolateral thalamic nucleus and subthalamic nucleus, as well as deep brain stimulation. In the case of severe akinetic-rigid syndrome, pallidotomy is recommended, as well as deep electrical stimulation of the pallidum and subthalamic nucleus.

Placebo

The drug has no medicinal effect, its effectiveness lies in the patient’s faith that he will recover. Lactose is simply added to the capsule, therefore it is also called “dummy”. But recent trials have shown that when taking a placebo in patients experiencing muscle soreness, depression, nausea and fatigue, the areas of the brain responsible for stress and pain are activated.

Drug treatment

The neurologist prescribes one or more drugs, depending on the stage of development of the disease: Levodop, Madopar, Amantadin, Miralex, Rotigotin.

Gymnastics

Exercise is extremely important to the patient. In addition to the assigned exercise therapy complex, it is necessary to walk, do work in the country, swim in the pool, and engage in fine motor skills of hands: sewing, embroidering, knitting, writing, etc.

What traditional medicine says

Before using prescriptions, discuss the issue with your doctor. Since there is no connection between the causes of Parkinson’s disease in men and women and treatment with folk remedies.

Alcohol tincture from peony root and broth from sage will definitely not harm.

General principles of therapy

The treatment of Parkinson’s disease is taken by a neuropathologist, who is registered with a patient who is forced to adhere to special restrictions. Strict adherence to the prescriptions of the attending physician contributes to a noticeable improvement in the quality of life, a decrease in anxiety symptoms, and an extension of remission episodes. To effectively treat a genetically based disease, traditional medicine suggests following a comprehensive program:

Methods of neurosurgery allow, through surgery, to block the symptoms of tremors, which improves the prognosis.
The help of physical therapy is necessary to increase physical activity. Strengthening the muscles helps to reduce limb tremors.
Psychotherapy techniques help teach the patient to control emotions for a calm perception of a new state of life.
The task of drug therapy is based on inhibition of processes that destroy neurons by replenishing the dopamine deficiency.

A person suffering from trembling syndrome will have to change not only the way of their usual life, but also the dietary system, switching to a complete vegetarianism. Physical activity with simple training complexes should become daily. Although the use of folk remedies alone will not cure Parkinson’s syndrome, recipes can alleviate symptoms, relieve nervous tension.

Surgery

The successes of conservative methods of treatment are undoubtedly significant and obvious, but their possibilities, as practice shows, are not unlimited. The need to search for something new in the treatment of Parkinson’s disease made not only neurologists, but also surgical doctors think about this issue. The results achieved, although they cannot be considered final, are already beginning to be encouraging and encouraging.

At present, destructive operations are already well mastered. These include interventions such as thalamotomy, which is effective in cases where tremor is the main symptom, and pallidotomy, the main indication of which is movement disorders. Unfortunately, the presence of contraindications and the high risk of complications do not allow the widespread use of these operations.

The introduction of radiosurgical methods of treatment into practice led to a breakthrough in the fight against parkinsonism.

Neurostimulation, which is a minimally invasive surgery – the implantation of a pacemaker (neurostimulator) similar to an artificial pacemaker (heart pacemaker, but only for the brain), which is so familiar to some patients, is performed under the guidance of MRI (magnetic resonance imaging). Electric stimulation of the deep brain structures responsible for motor activity gives hope and grounds to count on the effectiveness of such treatment. However, it also has its own pluses and minuses.

The advantages of neurostimulation include:

Safety;
Quite high efficiency;
Reversibility (as opposed to destructive operations, which are irreversible);
Good patient tolerance.

The disadvantages include:

Large material costs for the patient’s family (the operation is not affordable for everyone);
Breakage of electrodes, replacement of the generator after several years of operation;
The risk of infection (small – up to 5%).

Brain neurostimulation

This is a new and rather encouraging method of treatment not only for Parkinson’s disease, but also for epilepsy. The essence of this technique is that electrodes are implanted into the patient’s brain, which are connected to a neurostimulator installed subcutaneously in the chest area.

The neurostimulator delivers impulses to the electrodes, which leads to the normalization of brain activity, in particular, those structures that are responsible for the onset of symptoms of Parkinson’s disease. In developed countries, the neurostimulation technique is actively used and gives excellent results.

Stem cell therapy

The results of the first trials on the use of stem cells in Parkinson’s disease were published in 2009.

According to the data obtained, after 36 months after the introduction of stem cells, a positive effect was noted in 80% of patients. Treatment consists of transplanting differentiated stem cell neurons into the brain. In theory, they should replace dead dopamine-secreting cells. The method for the second half of 2011 has not been sufficiently researched and has no wide clinical application.

In 2003, for the first time in a person with Parkinson’s disease, genetic vectors containing a gene responsible for the synthesis of glutamate decarboxylase were introduced into the subthalamic nucleus. This enzyme reduces the activity of the subthalamic nucleus. As a result, it has a positive therapeutic effect. Despite the obtained good results of treatment, in the first half of 2011 the technique is practically not used and is in the stage of clinical trials.

Medicines overview

Medications used at an early stage of the disease are also antiviral drugs (Amantadine). To prevent the breakdown of the neurotransmitter, dopaminomimetics are prescribed, similar to the action of antidepressants. Amantadine is one of the first choice drugs for the treatment of the initial manifestations of parkinsonism. Taking an antiviral agent with an antiparkinsonian effect is manifested by the stimulation of dopamine synthesis, a decrease in its reuptake.

Protection of neurons is provided by blockade of glutamate receptors against the background of decreased rigidity and hypokinesia, but the effect on tremor is minimal.

For the first time, Parkinson’s disease was described by the English physician James Parkinson (1817), his birthday on April 11 later became World Day against pathology.

For monotherapy of the early stage of Parkinson’s disease, Miralax is considered to be no less relevant, the tablets of which are often prescribed in conjunction with Levodopa. This combination is effective for the treatment of advanced neurological pathology. Although the drug has more side effects than Amantadine, there are much fewer of them than non-selective agonists. The most dangerous side effect for people with dementia is the likelihood of developing hallucinations.

Basic medicines for Parkinson’s disease

From the third stage of the disease, the connection of funds containing levodopa is considered relevant. Thanks to the precursors of dopamine, the reduced level of the neurotransmitter is compensated. The process turns into relief of the main symptoms, which inhibits the development of the syndrome. The dosage of drugs based on levodopa is selected individually, focusing on the response of the patient’s body. For the symptomatic treatment of Parkinson’s disease, auxiliary drugs are used:

with the help of psychoanaleptics and neuroleptics, they remove signs of psychosis, hallucinations;
manifestations of vegetative disorders are blocked with laxatives, antispasmodics;
insomnia and depression should be treated with antidepressants, sedative medications;
to increase concentration and improve memory, cholinesterase inhibitors and neurotropic agents are used.

If the debut of Parkinson’s disease is diagnosed in a patient who has crossed the 70-year-old milestone, they immediately begin to treat the disease with levodopa drugs. Although parkinsonism is classified as a senile disease, in medical practice there is a description of its juvenile form. For a woman, this pathology turns into a problem with the prospect of pregnancy.

Current treatment for Parkinson’s disease

This disease is currently incurable. The available methods only alleviate the symptoms, but do not eliminate the cause of the disease (which, as already mentioned, is unclear). Nevertheless, the technique of eliminating the symptoms of “tremor paralysis” has reached great heights over the years.

For a long time (beginning in the late nineteenth century), alkaloids, including anticholinergics, were the main drugs for the treatment of Parkinson’s disease. Such substances block acetylcholine, a natural mediator that transmits neuromuscular impulses. In 1939, the first attempt was made to treat the disease surgically – by destroying the basal nuclei in the deep parts of the brain. All these methods, despite their certain disadvantages, were widely used in medicine.

Much later, levodopa was developed – an analogue of dihydroxyphenylalanine, which is produced in the body of a healthy person and serves as the basis for the formation of dopamine. This is actually the introduction of dopamine itself into the body, except that it is not possible to introduce it in a ready-made form – it poorly overcomes the barrier between the circulatory system and the central nervous system (the so-called blood-brain barrier). Levodopa is currently the primary treatment for tremor symptoms. True, in patients under 70 years of age, levodopa can cause side effects, so they try to start treatment with other drugs.

Other drugs that are among the main ones are the so-called dopamine agonists. Agonists are substances that act on receptors and activate them. In this case, agonists “awaken” dopamine receptors, mimicking the action of this substance. They are similar in effect to levodopa; at the same time, unlike her, they rarely cause dyskinesia and other side effects, however, they have their own side effects – nausea, dizziness, hallucinations, edema.

Surgical intervention is still used today. Operations are not only destructive (that is, destroying certain cells), but also neurostimulating. In the future, it is planned to treat the disease with stem cells, as well as drugs that can dissolve Lewy bodies.

Complications of Parkinson’s disease

Parkinson’s disease is not a fatal disease. A person dies with him, not from him. However, as symptoms worsen, they can cause incidents that lead to death. For example, in difficult cases, difficulty swallowing can cause patients to aspirate food into the lungs, leading to pneumonia or other pulmonary complications. Loss of balance can result in a fall, which in turn can result in serious injury or death. The severity of these incidents depends largely on the age of the patient, general health, and stage of the disease.

In the later stages of the disease, more pronounced symptoms of Parkinson’s disease appear: dyskinesia (involuntary movements or twitching of body parts that can occur as a result of prolonged use of levodopa, freezing (sudden inability to move) or mincing gait (short, almost running steps that seem accelerate by themselves).

It should be remembered that Parkinson’s disease is very individual in its course and each has its own scenario.

What do people with Parkinson’s disease look like?

For people suffering from Parkinson’s disease (see photo), stiffness of the whole body is characteristic, the arms are usually pressed to the body and bent at the elbows, the legs are parallel to each other, the body is slightly tilted forward, the head is extended, as if propped up by a pillow.

Sometimes you can notice a slight tremor of the whole body, especially the limbs, head, lower jaw, eyelids. Due to the paralysis of the facial muscles, the face acquires the expression of “mask”, that is, it does not express emotions, is calm, the person rarely blinks or smiles, the gaze lingers for a long time at one point.

The gait of Parkinson’s patients is very slow, clumsy, the steps are small, unstable, the hands do not move when walking, but remain pressed to the body. General weakness, malaise, depression are also noted.

Consequences for humans

“Tremor disease” is terrible already because it is impossible to completely recover from it at the moment. It is also terrible that the prognosis for this disease is most often unfavorable: the disease progresses slowly, worsening the patient’s condition. If at the initial stage it declares itself with minor tremors of the limbs, then in the future, serious disorders develop – both “bodily” and mental and mental. The case ends with dementia, complete immobility and death of the patient – as a rule, in a healthy state he could live much longer.

Sometimes one hears the opinion that “parkinson” is a completely natural consequence of too long a person’s life; supposedly the human body is not designed for the high life expectancy that occurs in developed and even most developing countries thanks to modern medicine and banal hygiene. This is fundamentally wrong: firstly, not always in antiquity and the Middle Ages, the life expectancy of people was short – the era of wars, natural disasters and epidemics were replaced by rather calm times in which medicine, culture and economy reached great heights, which is why people lived longer. Secondly, “parkinson’s” and other senile ailments are not so common among the older generation – many people live up to eighty, even a hundred years or more, without suffering any serious illnesses.

Aging and death are considered natural processes, and many have a calm attitude towards senile diseases. However, there is a growing conviction among the public, including the scientific community, that aging and even death are in themselves diseases that are necessary and, interestingly, can be treated. Among the grounds for such a statement is the finding in nature of animals that are actually immortal and regularly rejuvenate their body. We are talking about some types of jellyfish and other coelenterates; in unicellular organisms, death as such is also absent – the existence of one individual ends with the fact that it is divided into several daughter ones. Such organisms can die only for external reasons – due to diseases or being eaten by other organisms. In this regard, assumptions are made

In light of this, “parkinson”, “alzheimer” and other similar diseases are among the most important obstacles, the elimination of which must be organized first of all. Of course, not all people dream of living long – there are many who get tired of life even at a fairly young age; however, there is a large percentage of those who are ready to live practically forever, if they have such an opportunity.

Parkinson’s disease and life expectancy

How long do people live with Parkinson’s?

There is evidence from a serious study by British scientists that the age of onset of the disease affects life expectancy in Parkinson’s disease: – Persons whose disease began at the age of 25-39 years, live on average 38 years;

at the onset of 40-65 years old, live about 21 years;
and those who fall ill over the age of 65 live for about 5 years.

What to do if you suspect you have Parkinson’s disease

First of all, don’t panic. Almost all symptoms of Parkinson’s disease in the initial stages can be the result of some other disorders not related to neurology.

Therefore, first of all, you need to go to a doctor – a therapist or a neurologist. The specialist will study your medical history, ask questions about nutrition, bad habits, lifestyle. You may need to undergo blood and urine tests, MRI, CT and ultrasound of the brain to rule out other diseases.

But even after receiving the research results, the doctor often has doubts. Your healthcare provider may recommend that you see a neurologist regularly to assess how your symptoms and condition have changed over time.

If Parkinson’s is diagnosed, your doctor will prescribe medications that can slow down cell death in the brain. This will relieve symptoms and prolong your healthy life for many more years.

Advice

Despite the fact that this article is about Parkinson’s disease, it does not contain any medical advice or recommendations. If you think you are having symptoms of this disease, you should see your doctor anyway.
Parkinson’s disease is generally easier to recognize than other progressive and degenerative diseases and can be detected and effectively treated early on.
Medication and a healthy lifestyle can significantly reduce the impact of Parkinson’s on your daily life and slow its progression.
Remember that this diagnosis can only be made by a qualified doctor. You may suspect and even be sure that you have Parkinson’s disease, but only a doctor can establish an accurate diagnosis.

Recommendations for people with Parkinson’s

Don’t be alone! It is recommended to constantly be among people. This will help eliminate speech slowdown, return mobility – when you want to move somewhere, it turns out with less effort.

If it is difficult for relatives to stay close to a pensioner around the clock, you should think about a boarding house where they will provide decent care for such a person.

Prevention

Unfortunately, at the moment there are no special techniques that would with one hundred percent probability prevent the occurrence of this pathology.

In any case, you need to try to lead a healthy lifestyle:

do not abuse alcohol;
Do not smoke;
avoid stressful situations;
try to eat right;
be sure to play sports;
be in the fresh air more often.

The most important thing is to be attentive and sensitive to yourself and your loved ones. Remember that the symptoms of Parkinson’s disease in the initial stage do not appear simultaneously, but gradually. Be vigilant – contacting medical professionals at an early stage of the development of the disease will help you slow down the degenerative process.

Walk often, eat healthy foods, and quit alcohol and smoking. And just be healthy!

Sources used and useful links on the topic: https://nervy-expert.ru/bolezni/bolezn-parkinsona/simptomye-bolezni-parkinsona/ https://netbolezni.net/nevrologiya/789-bolezn-parkinsona-u-zhenschin- simptomy-i-priznaki.html https://www.pansion-zabota.ru/info/articles/bolezn-parkinsona-chto-eto-za-zabolevanie-prostymi-slovami-prichiny-razvitiya-bolezni-otkuda-beretsya/ https: //aif.ru/health/life/punktualnaya_bolezn_kakie_rannie_priznaki_ukazhut_na_parkinsonizm https://zen.yandex.ru/media/id/595f61ded7d0a69b431e48f9/chto-takoe-bolezn-parkinsona-i-chem-ona-opasna-5dafe48234808200afbfb642 https: // health50 .ru / zabolevaniya / nevrologiya / bolezn-parkinsona.html https://www.pansion-zabota.ru/info/articles/kak-raspoznat-bolezn-parkinsona-na-ranney-stadii-pervye-simptomy-i-priznaki/ https://www.KrasotaiMedicina.ru/diseases/zabolevanija_neurology/parkinson https://newneuro.ru/bolezn-parkinsona/ https://doctor-365.net/bolezn-parkinsona/ https://PsyLogik.ru/10-bolezn-parkinsona.html https://ProBolezny.ru/bolezn-parkinsona/ https://Lifehacker.ru/bolezn-parkinsona/ https://ru.wikihow.com/%D0%B4%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D1%80%D0%BE%D0%B2%D0%B0%D1%82%D1%8C-%D0%B1%D0%BE%D0%BB%D0%B5%D0%B7%D0%BD%D1%8C-%D0%9F%D0%B0%D1%80%D0%BA%D0%B8%D0%BD%D1%81%D0%BE%D0%BD%D0%B0

Post source: lastici.ru