PARKINSON'S DISEASE AND THE TREATMENT PROCESS
Parkinson's disease is a progressive, neurological disease caused by the destruction of dopaminergic neurons. Although Parkinson's occurs mostly in older ages, it can sometimes be seen in younger adults. Although the difference is small, it is more common in men than in women. This disease starts around the age of 60 on average. Although this slowly progressive disease has an average course rate, it is not possible to estimate a progression rate for each patient individually. To date, great advances have been made in diagnosis and treatment. Compared to previous periods, the death risk of Parkinson's patients has approached that of the general population and life expectancy has increased.
Four important findings of Parkinson's disease are involuntary tremor, muscle stiffness, slowness of movements (bradykinesia) and balance. is the loss. Although the most common initial symptom is asymmetric rest tremor, difficulty in using one hand is seen as the first symptom in approximately one fifth of patients.
In terms of other clinical features, in the early stages of the disease, the patient often notices difficulty in fine coordinated movements. It may become difficult to perform daily tasks (such as buttoning up buttons, combing hair, etc.). Facial expression, called mask face, may be noticed. The voice may become hoarse and monotonous. The arm that is having difficulty using may not swing fully while walking, and the patient may drag the foot on the same side while walking. The posture of the body gradually becomes bent and the steps become smaller; Handwriting may become smaller and deformed.
In later stages, drooling from the mouth, difficulties in swallowing food, and changes in taste due to loss of the sense of smell may occur. In addition, depression and dementia may also occur. Signs of autonomic dysfunction such as frequent urination and sweating abnormalities may be observed, as well as sleep disorders.
Clinical diagnosis of Parkinson's disease is made by evaluating the patient's anamnesis and performing a neurological examination. There is no laboratory or radiology method that provides a definitive diagnosis.
B.Stages of the Disease
One way to describe the severity of the disease is the Hoehn and Yahr scale, developed by Margaret Hoehn and Melvin Yahr in the 1960s. Staging according to this scale is as follows:
0:No signs of Parkinson's disease.
1. Stage:There are symptoms of Parkinson's disease (tremor, rigidity or bradykinesia) on one side.
2. Stage:There are bilateral Parkinson's disease symptoms (tremor, rigidity, or bradykinesia) and no walking difficulty.
3. Stage:There are bilateral Parkinson's disease symptoms and minimal walking difficulty.
4. Stage:There are bilateral Parkinson's disease symptoms and moderate walking difficulty. The patient is unable to live alone.
5. Stage:There are bilateral Parkinson's disease symptoms and the patient cannot walk. The patient must use a wheelchair or is bedridden.
C.Neurological Diseases that Mimic Parkinson's Disease
1.Arteriosclerotic (due to vascular circulation disorder) Parkinsonism
2.HIV Virus and Tuberculosis Infections
3.Trauma
4.Normal Pressure Hydrocephalus
5.Tumors and Other Mass Lesions
D.Treatment
Treatments such as drug therapy, surgical treatments and other methods can be applied in Parkinson's disease. There is no definitive treatment for the disease, but the patient can live a quality life. reaches a level that will sustain it. The symptoms that appear, the age of the patient, and other diseases significantly affect the treatment. In drug treatment, attempts are made to replace the dopamine substance that is secreted incompletely or not at all. However, these drugs and their dosage must be determined correctly. Otherwise, these drugs have serious side effects. Surgical methods may be preferred in patients where medications are not sufficient or have serious side effects. In surgical treatment, some special nuclei in the brain are stimulated by burning or by giving signals through special electrodes (DBS: deep brain stimulation). These very effective treatments should be followed carefully and accurately.
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