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Causes, symptoms, stages, how to treat Parkinson's disease?

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What is Parkinson's disease?

Parkinson's disease is a degenerative changes in the Central nervous system, with the ability to progress at a low speed. The first symptoms of the disease were described by doctor D. Parkinson in 1877. At that time he defined the disease as the shaking palsy. This is due to the fact that the main signs of CNS are manifested in the extremities tremor, muscle rigidity and slowness of movements.

With regard to statistics, the disease affects 0.4% of the population to reach 40 years. Older people, namely after the age of 65 years are more often faced with this problem, about 5% of cases. Parkinson's disease affects 1% of the elderly population to 60 years. Rarely, but still there are the juvenile form of the disease, when the debut have on the child's age. In this case, doctors say about juvenile parkinsonism. As for gender, that disease are more prone to men than women.

Life expectancy in Parkinson's disease

The life expectancy of a person suffering from Parkinson's disease, according to the earliest research conducted by the Japanese, is about 7.4 years. However, recent data indicate that this figure is significantly understated.

It depends on a number of factors, namely:

  • from the early start of therapeutic treatment
  • from the country of residence of the patient
  • the quality of patient care
  • from timely diagnosis, etc.

Recent data suggest that the disease is definitely progressing, but slow its development.

Some researchers come to the conclusion that the disease started at a young age, does not affect life expectancy. Studies conducted in the UK, offer hope to young people with Parkinson's disease, because they indicate that if the disease started at the age of 40, the average life expectancy is 39 years. This suggests that people will be able to live to a ripe old age. If the agediseased varies in the range from 40 to 65 years, life expectancy with proper care is 21. In older age, the disease progresses faster and, on average, people with the diagnosis live 5 years. However, be aware that leading to death of the disease, such as pneumonia or heart problems and blood vessels appear in person to 70 years and without Parkinson's disease.

Is there any Parkinson's disease inherited?

Genetics over a long period of time studying the question, is there any Parkinson's disease inherited.

However, formulating an exact answer to this question, there are certain obstacles:

  • First, the manifestation of the disease often in the later age at which many family members simply cannot survive.
  • Second, studies show that in one country, for example, in Bulgaria, family history of the disease occurs in 2.5% of cases. In Sweden and Norway, the disease is more common in people with 0 blood group, and Finland, on the contrary, such patients not. Therefore, to determine what influences the development of disease – genetic predisposition, or location, or blood type, or other factors is not possible.
  • Thirdly, the impossibility of studying the causes of vertical transmission in animals as they do not have the necessary gene and the disease does not develop.

However, many scholars have stated and continue to state that the disease is inherited, although, so far, no scientific justification was provided. In contrast to these claims, other researchers indicate that a very small number of people suffering from Parkinson's disease, have close relatives with similar pathology. However, the disease is more common in those families, where it manifests at an early age.

Special attention is given the youth parkinsonism. It is hereditary and occurs in children from 6 to 16 years. The disease is very slowly progressing does not lead to violations of memory, and the autonomic nervous system. Thus, the most reliable conclusion arrived at by modern scientists is that the hereditary form of the disease manifests in every tenth patient.


The first signs of Parkinson's disease

It has long been established that no motor symptoms are the first signs of the disease can show itself, even a few years, before the development of the main symptoms.

Among them we can mention the following:

  • Hyposmia. Hyposmia is reflected in the fact that the person is impaired sense of smell. The symptom is found in 80% of patients with Parkinson's disease.

  • Depression. In some patients it is accompanied by anxiety manifested many years before the start of the disease.
  • Constipation, is observed as an early sign of illness in more than half of the people. The act of defecation is present in less than 1 time per day.
  • Sleep disorders. They are characterized by frequent sklikivanie, falls from bed, involuntary movements of arms and legs. These disorders are manifested in the phase of sleep, which is rapid eye movement.
  • Disorders in the genitourinary system.
  • Apathy.
  • Fatigue. In emerging prostration, the patient becomes more difficult to perform daily chores: cook dinner, clean and even take care of themselves.

So, the first signs of the disease are determined by the violations in various fields in sensitive, neuropsychiatric, autonomic. This is due to the fact that until, until the pathological process reaches the substantia nigra, previously he will have an impact on extramurally structure of the brain. It is the olfactory system, the peripheral autonomic nervous system and the lower sections of the trunk of the GM.

Among movement disorders at the initial stage of development of the disease we can distinguish the pattern change. The letters become smaller, the person fails to clearly label them.

Can be jerking of the fingers on the hand and muscle stiffness of the face. This is reflected in the fact that it becomes like a mask-less blinking, more slowly speaks, his speech is not quite legible for others. The symptoms are somewhat worse when a person is nervous or is under stress. As calm, disease symptoms disappear completely. There is often a symptom of restless legs, when a person commits involuntary mincing of movement during the night's rest.

The difficulty in diagnosis lies in the fact that the first signs to notice very difficult, as most people consider them to natural processes occurring in the body, and do not seek help to the doctor. Toalso from the moment the first signs until symptoms, is a fairly long time period. Therefore, even if a person goes to the doctor, it is often treated for other diseases, mistakenly setting the wrong diagnosis.


The symptoms of Parkinson's disease

The symptoms of the disease are expressed primarily in the motor disorders. However, there are also other manifestations of the pathological changes of brain structures.

A full range of symptoms the following:

  • Tremor of the limbs. This symptom is impossible not to notice. It manifests itself at rest, but sometimes there are other types, in particular, postural tremor. It is characterized by the fact that the limb is shaking, if she's trying to hold in a certain position. Sometimes in Parkinson's disease manifested intention tremor, tremors in which are motor pattern. Often the following can be observed: tremor of rest, the patient is distinguished by the rough movements, much weaker than is evident postural tremor, and is present but very weakly pronounced intention tremor. Such symptoms characteristic of the shaking forms of parkinsonism.

  • Rhythmic podragivanija eyelids, jaw and tongue.

  • Rigidity of the muscles. This symptom appears weak in the early stages of disease development and more pronounced in its late stages. The muscles are in constant tension. In connection with increased tone, the man eventually produced the so-called "a pose of the applicant". Back hunched, arms and legs at the knee and elbow joints bent. In connection with the constant presence of the tone, the typical patient experiences of muscle and joint pain.

  • Hypokinesia. This symptom manifests itself in a delayed and reduced all movement and is present in any form of the disease. Parallel decrease in the speed of actions, reduced the amplitude of zvigeni. Suffers it, plastic, facial expressions, gestures.

  • Postural disorders. They occur in Parkinson's disease that alters the gait and posture of a person. The patient becomes increasingly difficult to keep the center of gravity, which leads to frequent falls. To turn in the direction of the preliminary marking time in one place. Gait is shuffling, festinating.

  • Drooling is another symptom of the symptoms of the disease. In connection withthe increase in the volume of saliva, the person's speech becomes slurred, difficult ability to swallow.

     

  • Violation of intellectual abilities. Suffers from attention, memory, speech, thinking, logic. Reduced learning capability, there can be personality changes. This symptom is called dementia, although in some forms of the disease it is not revealed, but if it begins to develop, it has been steadily progressing.

  • Depression is a constant companion of the patient and acquires a chronic form.

  • Men on the background of Parkinson's disease develops impotence.


The causes of Parkinson's disease

In order to determine the causes of the disease, it is necessary to understand the processes of transmission of nerve impulses. In the depths of the brain there is an area of the basal ganglia. If a person needs to take a specific action, for example, to take a step, nerve cells coordinate this action with ganglia and body position changes. Ganglia process the received signal and the nerve pathways to transmit it to the thalamus, and the back to the cortex.

If begins to develop the disease, the cells that are formed in the ganglia degenerate, the production of dopamine is reduced (it is the main conduit of signals between nerve cells), nerve connections are disrupted, and gradually lost. This leads to the development of disease symptoms. Often causes degeneration of nerve cells remain unclear, and the disease named as idiopathic.

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Among the reasons leading to the development of the disease, succumbed to the establishment, are the following:

  • Viral encephalitis as its late complication has Parkinson's disease.

  • Receiving neuroleptic drugs that are often used in the treatment of schizophrenia or paranoia. The disease is due to the fact that these remedies block the production of dopamine, disrupting the communication between nerve cells.

  • Receiving opiate narcotics.
  • Exposure to high doses of manganese on the body. Therefore, often the disease develops in miners.
  • The impact on the body high concentrations of carbon monoxide.
  • Natural aging of the body, the result is reduced process development of neurons.
  • The trauma of the brain. Especially dangerous, repetitive trauma, such as boxers get.

  • Atherosclerosis of blood vessels.

  • Tumors of the brain.

At issue is the role of genetic factors in the development of the disease.

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Stages of Parkinson's disease

The disease does not occur spontaneously, it progresses slowly during this time, takes six stages. Each has characteristic symptoms and signs:

  • Zero stage is characterized by the fact that the disease did not detect, however, it has already started to develop and to affect certain areas of the brain. At an early stage begins to progress forgetfulness, confusion, changes of smell and other signs.
  • The first stage is characterized by the fact that the disease manifested unilaterally. That is, the limb is struck on one side. However, at this stage, patients rarely seek help because the symptoms are mild. Tremor is barely visible, only enhanced with nervous excitement. However, the helpful relatives and friends may notice that a loved one has changed posture, speech, facial expressions.
  • The second stage is characterized by the fact that the symptoms of disease develop bilateral. At the initial stage, the signs of postural instability subtle, but as the progression of the disease, they begin to appear. Broken balance of the body, difficulties with balance, symptoms become more pronounced. Person more difficult to cope with physical exertion.
  • In the third stage, postural instability is moderate, however, the patient is able to do without the help of strangers.
  • The fourth stage causes a person to turn to family and friends for support. The patient loses the motor activity, is unable to walk independently, however, sometimes able to stand without support.

At last, the fifth stage, the person is bedridden.

The early stage of Parkinson's disease

Early stage disease is characterized by the absence of pronouncedsymptoms. So pay attention, it is important for the manifestation of such features as:

  • Hypokinesia. It is reflected in the fact that man becomes difficult to make such a seemingly basic actions: brushing teeth, pressing the button on the control panel, typing on the keyboard, writing lowercase letters, putting on Slippers etc.
  • In some cases, even in the early stages of disease development it is possible to detect a change characteristic of specific human gait pattern. With one leg beginning to lag behind the other.
  • The voice becomes a little weaker person speaks quieter, some phrases can be difficult. Especially hard to pronounce the patient becomes morphologically complex words.
  • In some patients observed pain in the shoulder, elbow, knee joints, due to muscle rigidity. Rest tremor is slow and latent. Often it is manifested classically by type "accounts coin"and"rolling pills."
  • If the disease is suspected in a young person, it is often the first manifestation is dystonia of the foot. This symptom is particularly noticeable when walking and is manifested in the emphasis on the outer edge of the foot and plantar flexion of the fingers.
  • In the early stages of the disease, patients present emotional depression, irritability and constant fatigue. There are cases of profuse perspiration, when a person starts to sweat being in a cold room.

  • Increased salivation, especially at night. Observed erectile dysfunction.

The last stage of Parkinson's disease

With progressive parkinsonism in the later stages of the disease to the person it becomes harder to keep balance. He constantly needs support not to fall. Also the last stage is characterized by loss of automaticity of movements. This is reflected in the fact that the usual actions that a healthy person does without any effort, without even thinking over them, the patient becomes inaccessible. We are talking about the blinking, synchronized movement of the arms during walking. Sometimes when you try to get up, the man involuntarily runs forward, trying to catch its own body.

Facial expressions of the patient in the later stages of disease development is frozen, as if scowling. Lost not only facial expressions but also gestures. The voice becomes quiet, monotonous speech. You also lose the ability to intone. Eventually, the person loses mobility.

The patient harder to swallow hard himself. Some patients prone to develop dementia.


The effects of Parkinson's disease

The effects of Parkinson's disease is very serious, and they occur faster, the later treatment begins:

  • Akinesia, that is, the impossibility of movement. But, it is worth noting that the complete immobility occurs rarely and in the most severe cases.
  • Often, people are faced with the deterioration of the musculoskeletal system of different severity.

  • Constipation, which sometimes led even to death. This is due to the fact that patients are not able to consume food and water in the proper quantity to stimulate normal bowel function.

  • Irritation of the visual apparatus, due to the decrease in the number of the blink movements of the eyelids up to 4 times per minute. Against this background, often appear conjunctivitis, inflamed eyelids.

  • Seborrhea is another complication, often chasing people with Parkinson's disease.

  • Dementia. It is reflected in the fact that a person becomes withdrawn, inactive, prone to depression and emotional poverty. If you join the dementia, the prognosis of the disease significantly worse.

Diagnosis of Parkinson's disease

Diagnosis of the disease includes three stages, allowing to establish for certain the diagnosis:

  • First and foremost, the doctor is obliged to recognize the syndrome of parkinsonism and differentiate it from other neurological disorders. Specific signs that allow the doctor to define Parkinson's disease are hypokinesia, combined with rest tremor, muscle rigidity and postural instability.

  • At the next stage the doctor is important to exclude all possible diseases with similar symptoms. It can be ekologichnye crises, recurrent stroke, secondary to traumatic brain injury, brain tumor, poisoning, etc.

  • The final stage of diagnosis is based on the presence of at least three signs. It's a disease duration of more than 10 years, disease progression, asymmetry of symptoms with a predominance on the side of the body, which debuted illness, presence of tremor rest, the unilateral manifestation of the disease at the initial stage of its development. In addition, the patient must respond to levodopoutherapy, which has been and remains effective for 5 years or more.

In addition to these three diagnostic stages neurological examination, people can be sent to the EEG, CT or MRI of the brain. Apply reoentsefalografii.

Another very expensive method of detecting decrease in the concentration of dopamine in the brain is to conduct positron emission tomography.


How to treat Parkinson's disease?

For the treatment of disease is used a large amount of drugs. However, once it is understood that to heal the pathology completely with them will fail. They are able to stop or at some time slow down its development, to improve motor activity in patients, to give people the opportunity, for as long as possible to remain operational and not bedridden.

In particular, such a drug like Levodopa is able to be transformed in the brain into dopamine. This helps to ensure that the patient to decrease tremor and muscle rigidity, movements will become easier and more affordable to implement. A timely start allows Levodopa to patients at an early stage to normalize the activity of the former. Those patients who have been partially paralyzed, regain the ability to move.

Levodopa is often supplemented with Carbidopa, which allows you to increase the effectiveness of the first drug with regards to the impact on the brain. In parallel Carbidopa reduces the side effects of Levodopa in relation to the organism as a whole. In particular, reduced the frequency of involuntary movements of the mouth, limbs, face. Often, when a person for a long time is taking Levodopa, he suffers from involuntary movements of head, lips, tongue, jerking of the arms and legs. In order to reduce the risk of these and other side effects, many experts suggest replacing Levodopa on Bromkriptin. Or, to Supplement the basic treatment Levodopa this tool.

After a period of five years of taking Levodopa, a decrease in the effectiveness of this drug. This is manifested in the abrupt change hyperactivity into complete immobility. The introduction of the next dose does not bring relief. To control such conditions the doctors lower the dose of the drug, but injected it more often.

To alleviate the patient's condition helps physiotherapy, diet, physiotherapy.

Generally, diagnosis of Parkinson's disease does not mean that person will be immediately prescribed medication. For starters, the medical doctor will determine the pace of progression of the disease, its duration, the severity, the stage, presence of concomitant diseases and other factors. At the initial stage prescribed means inferior in its effectiveness Levodopa is Selegiline, Pramipexole, etc. Despite their not sopronounced effect for the first stages of the disease, these funds will be enough.

It is understood that how efficient would not have been chosen regimen, over time, the disease will still progress. So the mother is caring for someone with Parkinson's disease eventually require specialized care.

Surgical intervention is resorted to only in cases when the patient does not tolerate conservative therapy.

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Prevention of Parkinson's disease

In order to reduce the risk of Parkinson's disease, should adhere to the following preventive measures:

  • To comply with the submission deadlines neyrolepticheskih drugs. They can be used not more than 1 month without a break.

  • To diagnose and treat vascular diseases of the brain, associated with injuries or infections. It will also be able to avoid a dysfunction of dopamine production.

  • To go to the doctor when it detects any signs of Parkinson's disease.

  • More and more scientific evidence suggests that smokers and lovers of coffee drinks Parkinson's disease practically does not occur. But it's quite a specific preventive measure, which should not be viewed as a recommendation. In addition, when detection of the disease makes no sense to start Smoking or consuming coffee, since it has no impact on the course of pathological processes. However, in the absence of contraindications, it is possible to consume the minimum dose of the natural coffee on a regular basis.

  • Substances which are really able to protect neurons is flavonoids and anthocyanins. They can be found in apples and citrus.

  • It is necessary to protect the nervous system by avoiding stress, a healthy lifestyle, physical activity.

  • It is useful to stick to a diet that is rich in vitamins and fiber.

  • Avoid contact with harmful substances that affect the development of the disease, such as manganese, carbon monoxide, opiates, pesticides.

  • New research shows that berries are able to influence the risk of disease.

As for the forecast, the disease tends to progress steadily. People eventually ceasesthe ability to work, self-care, the lifespan is reduced. However, the duration of the normal life depends on how time was discovered the disease and how timely started therapy. Without treatment the person will be immobilized after 8 years, intake of Levodopa increases this period to 15 years.


What kind of doctor treats Parkinson's disease?

The management of patients with Parkinson's disease engaged in a neurologist. He makes a diagnosis and provides the patient and his family physician. The neurologist has certain techniques to accurately diagnose the disease, determine its stage and to prescribe treatment. If necessary, are connected in parallel. This can be an ophthalmologist, a therapist, cardiologist, endocrinologist, gerontologist, oncologist and other doctors.