Parkinson's is the most common, slowly progressive, neurodegenerative brain disease after Alzheimer's disease. Parkinson's disease, which is characterized by loss of brain cells, is characterized by symptoms such as slowed movements, tremors at rest, and a slight forward tilt of the body. This neurological disease, which is 50% more common in men than in women, can occur between the ages of 20 and 40, although it is mostly seen in people over the age of 60.
What is Parkinson's?
The disease, which was first described by James Parkinson in 1817 and entered the literature, has a 1% incidence in Turkey. The symptoms caused by the disease cause a decrease in the quality of life of the person. Parkinson's patients can live for many years with the right diagnosis and treatment. For this reason, when the symptoms of the disease are noticed, it is of great importance to consult a neurologist without delay and evaluate treatment options. Before moving on to the diagnosis and treatment methods of Parkinson's disease, "What is Parkinson's disease?" must answer the question.
Parkinson's is a neurodegenerative disease that progresses slowly and progresses with loss of brain cells (neurodegenerative). Parkinson's, also known as shaky palsy among the people, is mostly seen in individuals between the ages of 40 and 70. The incidence in men is 50% higher than in women. Due to the slowly progressive nature of the disease, Parkinson's patients can live for many years with treatment. Although the prominent symptoms of Parkinson's disease are tremor and limitation of movement, it causes many different symptoms to be seen in the person.
What are the Early (Early) Symptoms of Parkinson's Disease?
In the early stage of Parkinson's disease (Stage 1), tremors are seen in the hands and fingers on one side of the body. There is no arm swing during walking on the side where the tremor is observed. In some people, the tremors caused by Parkinson's disease may also occur in the tongue, jaw, or feet. The patient's facial expression, posture and gait deterioration Only the relatives of the patient notice the symptoms.
As the disease is progressive, clinical deterioration continues. Often in the third year after the onset of Parkinson's symptoms (Stage 2), symptoms appear on both sides of the body; little disability developed. Posture and gait are noticeably affected.
Recognition of Parkinson's symptoms is important for early diagnosis of the disease. With early diagnosis, the disease is treated at an early stage and its progression is slowed down. This improves one's quality of life.
In Stage 3, slowing of trunk movements, balance disorder and falls are added to the motor disorder. Moderately diffuse dysfunction is conspicuous. In stage 4, the patient can walk with difficulty. Movements are slow and there is rigidity in the body. Although the tremor decreases, the patient cannot do his/her work alone without assistance.
In the last stage of the disease, the patient's mobility is completely restricted; is bed- or wheelchair-bound and needs constant care. In order to understand the causes of the symptoms seen in Parkinson's disease, it is necessary to understand why Parkinson's occurs.
How Does Parkinson's Occur?
There are brain cells that produce dopamine in certain parts of the brain of every healthy individual. These cells are much denser in the area of the brain called the "substantia nigra".
- Thanks to the chemical called dopamine produced by brain cells, a healthy communication is established between the substantia nigra and the striatum, where body movements are controlled. causes the motor manifestations of Parkinson's disease. In other words, dopamine is a chemical that allows a person to perform harmonious and fluent movements.
- Disruptions in the enteric nervous system (ESS), lower brain stem and sense of smell, early signs of Parkinson's disease is among.
- Over time, the disease spreads from these regions to the substantia nigra region and the cerebral cortex.
What are Parkinson's Symptoms?
The symptoms of Parkinson's disease can be examined in two separate groups as motor (related to movement) and non-motor. The motor symptoms of Parkinson's include tremors, bradykinesia (slowing in movements), akinesia (inability to move), muscle and limb contractions, hunching, gait differences. Non-motor symptoms can be listed as loss of sense of smell, anxiety, depression, constipation, sleep and sexual dysfunctions. Parkinson's causes different symptoms in each person, and the initial symptoms may differ from person to person. Although Parkinson's symptoms can occur in almost every age group, the average age of onset of the disease is considered to be 60. It is very rare in individuals aged 30 years and younger.
As the symptoms of the disease differ from person to person, the progression of Parkinson's also differs. But often the first symptom is the slowing of the movements of one hand. This may be accompanied by decreased swinging of the arm and shoulder pain during walking. Balance problems may occur in some of the early Parkinson's patients. However, in some patients, the arms and legs may also tremble. Although Parkinson's is known as shaky palsy, about 15% of patients do not have tremors at all. The presence of tremor complaints helps most patients to get an early diagnosis. Parkinson's disease can be confused with typical signs of aging.
Decreased use of mimics, leaning forward slightly, slowing of movements and monotony of speech are common symptoms in the presence of Parkinson's. In addition, other symptoms such as arm, shoulder and neck pain, anxiety and depression may lead to a different diagnosis of the patient. Common Parkinson's symptoms The symptoms can be listed as follows:
- Drowning feet,
- Stiffness in one of the legs,
- Arm swinging does not accompany walking,
- Shortening of handwriting,
- Looking still without blinking (dive),
- Internal trembling sound,
- Softening in tone of voice,
- Differentiation in facial expression,
- Forward bending of the body,
- Drowsiness in the shoulder,
- Numbness, tingling in the neck and/or limbs.
How is Parkinson's Diagnosed?
After the person consults a neurologist with Parkinson's symptoms, the physician first listens to the patient's history and then performs a physical examination. The presence of two of the four main motor symptoms listed as tremors, slowness of movements, stiffness in the limbs or trunk, and balance problems makes it possible to think of Parkinson's disease.
Also, when the physician deems necessary to support the findings, he/she may request additional laboratory tests and radiological examinations. After evaluating all the data, the diagnosis of Parkinson's is made.
How to Treat Parkinson's?
Since Parkinson's is a disease that causes a decline in the quality of life of the person over time, it is important to raise awareness of the person himself and his family members. In addition, applying to a doctor at the first appearance of symptoms ensures that the disease is diagnosed at an early stage and therefore the patient responds better to treatment. Although the treatment of the disease is arranged in different ways according to the stage of the disease, it is primarily aimed that the person can continue his life without being dependent. For this, the person is prescribed drugs (Parkinson drugs) to help prevent the decrease of dopaminergic nerve signals. Some drugs can cause side effects in patients. In such cases, it is necessary to consult the doctor again before stopping the medication. Thus, the physician can change the drugs or the dose of the drug.
Surgical options are considered if Parkinson's disease cannot be corrected with medication. In the brain battery application, also known as deep brain stimulation, stimulation electrodes are placed in certain parts of the patient's brain, and batteries are placed in the chest or abdomen. Thanks to the brain battery that can be applied to selected cases, the complaints of the person can be reduced.
Additional to all treatment types As a result, the physician may recommend Parkinson's exercises to the patient. These can be physical therapy applications or types of exercises that the person can do on their own at home. In the early stages of the disease, the movement restriction of the patients is not obvious, so Parkinson's exercises prepared by the physiotherapist can be done comfortably. Exercises are basically planned to reduce muscle stiffness and increase mobility. It also helps to keep the self-confidence of the patient high. As the limitations increase in the advanced stages of the disease, a new exercise program can be prepared by the physiotherapist. The aim is to keep the patient active in the later stages of the disease. Major exercises; buttoning and unbuttoning, getting out of bed and lying down, dressing, mimic movements. As the limitations increase in the advanced stages of the disease, a new exercise program can be prepared by the physiotherapist. The aim is to keep the patient active in the later stages of the disease. Major exercises; buttoning and unbuttoning, getting out of bed and lying down, dressing, mimic movements. Patients whose speech is affected may be offered additional treatment, such as language therapy.
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