Parkinson's disease is a serious disease of the nervous system that affects neuron cells in the brain. Parkinson's disease is progressive. From a medical point of view, it is manifested by motor disorders, namely, weak motor activity, limited movements, muscle mobility in a state of complete rest, tremors of the limbs. The disease is also accompanied by the development of mental disorders - a person’s mental abilities decrease, and the state of depression increases.
The causes of Parkinson's disease can be different; the disease cannot be treated. Only through drug therapy can the symptoms of Parkinson's disease be relieved.
Medical prescriptions include a structured lifestyle, as well as physical exercises for balance and stretching. Speech problems will be corrected by a speech therapist.
Stages of Parkinson's disease
As the number of cells in the cerebral cortex that produce the neurotransmitter dopamine decreases, Parkinson's disease progresses more and more actively. As a result, the functioning of those parts of the brain that control involuntary movements of the limbs decreases.
Based on the severity of the symptoms of the disease, parkinsonism is divided into several stages . Each stage is characterized by its own characteristics and specific treatment. The Hoehn-Yahru scale is used to differentiate the stages of Parkinson's disease. According to this scale, the following stages of the disease are distinguished:
- Zero – the person has no obvious signs of pathology.
- The first is that there are slight disturbances in the movements of the fingers and hands, trembling of some limbs, which stops in a state of sleep or rest, depression, lethargy appears, and sleep is disturbed.
- The second is that motor disturbances appear on both sides, facial expressions worsen, the functioning of the sweat glands worsens, and processes associated with sweat secretion are disrupted. A person performs his daily work, but his movements are already becoming slow.
- Third, the face takes the form of a mask; a person acquires a certain pose in which he begins to be constantly; this pose is called the pose of a supplicant; muscle tone and tension increases; motor activity becomes very low.
- Fourth – there are disturbances in coordination of movements when walking, a person’s ability to maintain balance in one position or another decreases, problems appear with the functioning of the vestibular apparatus, in everyday life a person needs help and support from outside. At this stage, signs of dementia may appear.
- Fifth - obvious signs of a nervous system disorder - a person cannot move, eat, or control urination without the help of others. A person at this stage completely needs the care of loved ones; the speech he pronounces is difficult to perceive and understand.
Caring for Parkinson's Patients
Not only physical help is extremely important, but also psychological support. The patient needs to be helped in all endeavors, but where possible, allowed to act on his own. You also need to communicate with him a lot so that his mental abilities do not fade.
It is important to ensure that the pensioner does not forget to take medications. The course of the disease and the general condition of the elderly depend on this. A lack of necessary substances manifests itself in:
- unexpected passion for shopping;
- unconditional increase in appetite;
- sudden mood swings;
- passion for hoarding;
- depression;
- aggressiveness.
Pay attention to this and report any suspicious changes to your doctor! The patient may need to adjust the dose of the drug.
When the disease has passed from the first stage to the second and subsequent ones, one cannot do without a wheelchair and other devices that make movement easier. All things that could injure him or cause other harm should be removed from the patient’s room. The bathroom should be equipped with special handrails. This will help avoid falls and injuries.
Main signs and symptoms
It is impossible to prevent the occurrence of the disease in advance, since its occurrence is not associated with genetic predisposition. However, identifying signs of the disease in the early stages makes it possible to stop the further progressive course. At the initial stage, it is extremely difficult to detect the disease, because the nerve cells are just beginning to gradually deteriorate. With the transition of the disease to a new stage, new symptoms of nervous system disorders are observed. Parkinsonism changes a person at lightning speed.
Signs of Parkinson's disease at the initial stage
At the moment when the disease has not yet declared itself, it is difficult to determine the initial stage of destruction. But if you take a very strict approach to your health, you can detect the first signs of Parkinson's disease:
- the appearance of a slight trembling in the hands, which the patient may not feel at all,
- movements become slower
- a person may fall into a state of depression, have problems sleeping, and disrupt the functioning of the gastrointestinal tract.
When you notice the appearance of signs such as tremor, when walking, your arms do not make the usual sweeping movements, they remain pressed to the body, the motor activity of the limbs is disrupted, stooping when walking, poor facial expressions, which means that the brain cells have begun to produce less of the neurotransmitter dopamine and the pathology becomes wide coverage. Serious disorders of the nervous system appear.
Morbidity statistics
In terms of frequency of development among neurodegenerative pathologies, PD ranks second after Alzheimer's disease. According to WHO, the disease is quite widespread: in total, there are more than 6 million people in the world with such a complex diagnosis. The incidence rate in Russia corresponds to 140-160 cases per 100 thousand population. At the same time, from year to year a steady increase can be seen in the spread of pathology even among young people aged 30-40 years. According to statistics, every 10th patient is under 40 years of age. If the onset of PD occurs any year before the age of 40, it is called juvenile parkinsonism.
Based on the information provided by different authors, up to 55 years of age the morbidity risks average 0.5%, from 55-74 years old - 1.5%, 75-85 years old - 2.5-3%, over 85 years old - 4-4 ,5%. The most vulnerable group of people to the disease are men. Disability, as a rule, occurs 3-5 years after the manifestation of symptoms. The average survival rate is 15 years. Parkinson's disease is one of the diseases with relatively low mortality rates. The causes of death are mainly complications after a fall, lung infections, pulmonary embolism, and infectious pathogenesis of the urinary tract.
Signs on MRI.
Causes of Parkinson's disease
To date, a complete list of the causes of Parkinson's disease has not been fully identified. However, we can mention some factors that could trigger the development of this disease. Among them: aging, ecology (external environmental factors), heredity. There are cases when parkinsonism occurs as a result of a person having certain diseases.
Causes of Parkinson's disease:
- physiological old age of the body, in which case there is a natural decrease in the number of neurons that are responsible for the production of the neurotransmitter domafin;
- heredity;
- long-term residence near highways, operating enterprises or near railways;
- vitamin D deficiency, obtained from exposure to ultraviolet rays on our body, and also protects the structural cells of our brain from destruction;
- poisoning of the body with chemicals (for example, ethanol, carbon monoxide, technical alcohol, etc.);
- previous neuroinfections (for example, encephalitis);
- tumors and frequent brain injuries.
Our clinic has opened a treatment room for Parkinson's disease and extrapyramidal disorders.
Extrapyramidal disorders are diseases characterized by movement disorders. They can be either primary (occurring independently) or a consequence of other diseases.
Extrapyramidal diseases include diseases such as:
- Trembling of hands, head;
- Violent movements in the limbs and torso;
- Gait disturbances;
- Memory disorders.
The office is attended by highly qualified doctors - doctors and candidates of medical sciences, specializing in this section of neurology. We carry out a comprehensive clinical differential diagnosis of conditions associated with impaired motor functions, establish the cause of extrapyramidal disorders and prescribe adequate specialized treatment. The health status of patients is monitored.
With timely diagnosis and adequate treatment (drug therapy, use of botulinum toxin), patients experience long-term and stable remission, lost functions are restored and the quality of life is significantly improved.
Registration is carried out by phone
Specialized clinics
In Europe, one of the leaders in the field of neurosurgical treatment and rehabilitation of patients diagnosed with Parkinson's disease is the Czech Republic. The Czech Republic has extensive experience in restoring musculoskeletal functions and the lost potential of the central nervous system not only in Parkinsonism, but also in Alzheimer's disease, epilepsy, and brain tumors. Medical care is provided according to modern neurosurgery standards.
Czech specialists exclusively use proven, effective and gentle technologies that are relevant to the present time. Clinics in the Czech Republic are world-famous institutions that are not inferior to medical institutions in Germany and Israel. And at the same time, prices for radio- and neurosurgical care for parkinsonism in the Czech Republic are many times more affordable (at least 1.5 times lower) than in these countries.
Prevention of Parkinson's disease
In order to reduce the risk of developing Parkinson's disease, it is necessary to perform certain preventive actions:
- Promptly identify and promptly treat vascular pathologies of the brain that may appear due to injuries or previous infections.
- Do not forget to take special medications prescribed by your doctor.
- Seek medical advice if any signs of illness appear.
- Include a large amount of apples and citrus fruits in your diet, as these fruits contain substances that can protect brain neurons from damage.
- Try to avoid stressful situations, maintain a healthy lifestyle, and do physical exercise.
- Many scientists have proven the fact that smokers and coffee drinkers are least likely to suffer from this disease. But this does not mean that for safety reasons you need to start smoking and drinking large quantities of coffee. If there are no contraindications, you can drink coffee in small portions daily.
- It is recommended to expand your diet with foods rich in B vitamins and fiber.
- Avoid contact with chemicals such as carbon monoxide, manganese, etc. Since they have a strong influence on the development of the disease.
What do people with Parkinson's disease look like?
People who suffer from Parkinson's disease have difficulty moving. As a rule, their arms are always bent at the elbows, the body is tilted forward, and the head is slightly extended. Sometimes you can notice trembling of the body and limbs. Due to the fact that the facial muscles are affected, the face resembles a “mask” without any emotions. It is rare to see a patient blink or smile.
Walking in sick people is slow and clumsy, the steps are very small, and during movement the arms are always pressed to the body. Weakness, malaise, and constant depression appear.
Complications
Restriction of muscle function in Parkinson's disease inevitably leads to a decrease in the intensity of blood flow and a decrease in the level of metabolism. Already in the middle stages of the development of the disease, the risk of blood clots and the development of dangerous conditions increases significantly:
- ischemic or hemorrhagic stroke;
- myocardial infarction, angina pectoris, heart failure;
- pulmonary embolism.
Bedridden patients often face severe complications associated with a recumbent position:
- congestive pneumonia;
- aspiration pneumonia (due to impaired swallowing, food enters the respiratory tract);
- bedsore infection and sepsis.
Most patients experience apathy and severe depression, which lead to suicidal thoughts. Some patients carry out plans and commit suicide.
Correctly selected treatment significantly reduces the risk of complications, which is why it is important to consult a doctor in a timely manner.
Disability groups for Parkinson's disease
The disability group is established based on the results of a medical examination, during which the basic systems of the body are assessed, and the ability to care for oneself independently, communicate with people, move, and engage in work activities is tested.
There are 3 groups of disabilities, each of which has its own characteristics of the patient’s behavior:
- Group 1 – the patient is unable to care for himself or move independently. Labor activity is contraindicated and bed rest is prescribed.
- Group 2 – the person is partially able to take care of himself, symptoms of bilateral instability appear. Labor activity is limited.
- Group 3 – a person is fully capable of independent care. Labor activity is reduced.
Life expectancy with Parkinson's disease
The life expectancy of a patient suffering from parkinsonism is determined by a timely diagnosis and correctly prescribed treatment. If the disease is detected at an early stage, effective treatment is prescribed, physiotherapeutic procedures, massage, diet and a healthy lifestyle are prescribed, the patient’s life expectancy can significantly increase.
But you need to understand that Parkinson's disease cannot be completely cured. Therefore, the prognosis for this disease is extremely disappointing. Doctors are unable to stop the progressive development of the disease. It is caused by a number of genetic, physiological, and environmental factors. But, nevertheless, by following all the recommendations and prescribed treatment by the doctor, the development of the disease can be slowed down and the quality of life can be significantly improved.
Diagnostics
The first task of the doctor is to identify the causes of the disease. It is important to determine whether it is Parkinson's disease itself or whether the characteristic symptoms are a consequence of other ailments. Secondary parkinsonism can be caused by:
- increased blood pressure;
- head injuries;
- deposition of cholesterol on the walls of blood vessels;
- intoxication.
Diagnosis begins with an examination by a neurologist. Having prescribed therapy, the doctor constantly monitors the body’s response to medications. If the patient responds positively to medications designed specifically to treat Parkinson's disease, then the diagnosis is confirmed. Secondary parkinsonism is partially eliminated by other means.
In some cases, hardware diagnostics are performed using MRI and computed tomography.
Treatment of Parkinson's disease
This disease is practically untreatable, but modern medicine, as well as high achievements in the field of neurology, help cope with severe symptoms of the disease. Each specific case of treatment of a disease is considered by a doctor individually. The following treatment methods are currently used in medicine:
- drug therapy,
- surgical intervention,
- physical therapy and massage.
Medicines
Medicines help overcome difficulties with walking, movement and tremors. These drugs increase or replace dopamine, a specific signaling chemical (neurotransmitter) in the brain that is deficient in patients with Parkinson's disease. But dopamine cannot be given directly because it does not enter the brain. Let's take a closer look at what a disease such as Parkinson's disease is like and its treatment.
To increase dopamine levels, the following are prescribed:
- Carbidopa/Levodopa, the most effective antiparkinsonian drug. The substances included in its composition penetrate the brain, promoting the production of dopamine.
- Carbidopa-levodopa infusion is a combined drug in the form of a suspension; is supplied to the duodenum via an infusion pump. Recommended to alleviate the condition of patients with advanced disease.
- Dopamine agonists. Unlike levodopa, they are not converted into dopamine, but reproduce dopamine effects in the brain. Their effectiveness is not as high as that of levodopa, but the effect is longer.
Often prescribed together with levodopa to smooth out the side effects of the latter.
- Dopamine agonists: pramipexole (Mirapex), ropinirole (Requip), and rotigotine (Neupro). A short-acting dopamine agonist, apomorphine (Apokyn), has been developed for rapid relief.
- MAO-B inhibitors. These include selegiline (Eldepryl, Zelapar) and rasagiline (Azilect). They slow down the destruction of dopamine by inhibiting brain monoamine oxidase B (MAO-B).
When added to carbidopa-levodopa, these medications increase the possibility of hallucinations.
- Catechol-o-methyltransferases (COMT inhibitors). Entacapone (Comtan) is the main drug in this class. It gently prolongs the effect of levodopa by blocking the enzyme that breaks down dopamine.
- Tolcapone (Tasmar); another COMT inhibitor that is rarely prescribed due to the risk of serious liver damage and liver failure.
- Anticholinergics. Helps control limb tremors. Several anticholinergic drugs are available, such as benztropine (Cogentin) or trihexyphenidyl.
Their modest benefits are often offset by side effects: memory loss, confusion, hallucinations, constipation, dry mouth and urinary problems.
- Amantadine. Doctors may prescribe amantadine alone to provide short-term relief from symptoms of mild, early-stage Parkinson's disease. In later stages, they may be prescribed together with carbidopa-levodopa to control involuntary movements (dyskinesias) caused by carbidopa-levodopa.
Folk remedies
For the complex treatment of this disease, herbal decoctions are used. They are used both externally and internally. Decoctions of fern roots are used for foot baths, and hands are rubbed with jasmine flower oil. Depending on what symptom of the disease you want to cope with, various medicinal herbs are used.
It is also important to maintain an active lifestyle during the treatment period, supplement your diet with vegetables and fruits, and stop drinking and smoking. The diet must contain foods that will activate the brain (for example, nuts, seafood). In the absence of contraindications, you can increase the amount of fluid consumed. Failure to eat a balanced, proper diet can overload the body.
Physiotherapy
The effectiveness of physical therapy in treating the disease has been proven by many. It increases blood circulation and motor activity of the limbs. Good for relieving limb tremors. When treating Parkinson's disease, you can perform the following simple exercises:
- stretching,
- circular movements of the hands and shoulders,
- twisting the body in a standing and sitting position,
- tilts of the head, body,
- raising your legs parallel to the floor,
- neck stretch.
Doctors recommend several useful approaches to treating the disease that will help cope with the further development of the pathology. This includes frequent stay in the fresh air, physical activity; to control speech, you can read books out loud to monitor the correct pronunciation.
Massage
With an integrated approach to treating the disease, it is effective to undergo massage sessions, which are carried out using special techniques and techniques. This makes Parkinson's disease easier. The impact on different muscle groups of the limbs helps restore their activity and has a positive effect on the nervous system.
Surgical intervention in treatment
Often Parkinson's disease, regardless of the causes and methods of treatment, progresses. In this case, deep brain stimulation (DBS) is used. Electrodes are implanted in the brain and connected to a generator, which is implanted in the chest near the collarbone. The device transmits electrical signals to the brain; as a result, symptoms become less severe.
The doctor adjusts the settings depending on the patient’s condition. Surgery comes with risks, including infection, stroke or brain hemorrhage.
DBS can stabilize the effects of medications, reduce or stop reflexive movements (dyskinesias), reduce tremors, and improve and slow movements. But although DBS relieves the symptoms of Parkinson's disease, the procedure is not able to stop the development of the disease.
