This term is unfamiliar to the ear of many patients. In our country, doctors rarely use it and display these ailments in a separate group. However, in world medicine, in the lexicon of doctors, the term "degenerative diseases" is constantly found. Their group includes those pathologies that are constantly progressing, provoking a deterioration in the functioning of tissues, organs, and their structure. In degenerative diseases, cells are constantly changing, their condition worsens, and this affects tissues and organs. In this case, the word "degeneration" means a steady and gradual degeneration, deterioration of something.
Hereditary-degenerative diseases
Diseases of this group are completely heterogeneous clinically, but they are characterized by a similar course. At any time, a he althy adult or child can spontaneously fall ill after exposure to some provoking factors, the central nervous system, as well as other systems and organs, can suffer. Clinical symptoms gradually increase, the patient's condition steadily worsens. Progression is variable. Hereditary degenerativedystrophic diseases eventually lead to the fact that a person loses many basic functions (speech, movement, vision, hearing, thought processes, and others). Very often, such diseases are fatal.
Pathological genes can be called the cause of hereditary degenerative diseases. For this reason, the age of manifestation of the disease is difficult to calculate, it depends on the expression of the gene. The severity of the disease will be more pronounced with the active manifestation of pathological signs of the gene.
Already in the 19th century, neurologists described similar diseases, but could not explain the reason for their appearance. Modern neurology, thanks to molecular genetics, has discovered many biochemical defects in the genes that are responsible for the development of symptoms of this group of diseases. By tradition, the symptoms are given eponymous names, this is a tribute to the work of scientists who first described these diseases.
Characteristics of degenerative diseases
Degenerative-dystrophic diseases have similar features. These include:
- The onset of diseases is almost imperceptible, but all of them are steadily progressing, which can last for decades.
- The beginning is difficult to trace, the cause cannot be identified.
- Affected tissues and organs gradually refuse to perform their functions, degeneration is on the rise.
- Diseases of this group are resistant to therapy, treatment is always complex, complex and rarely effective. Most often, it does notdesired results. It is possible to slow down degenerative growth, but it is almost impossible to stop it.
- Diseases are more common among older people, the elderly, they are less common among young people.
- Often, diseases are linked to a genetic predisposition. The disease can occur in several people in the same family.
The most famous diseases
The most common and known degenerative diseases:
- atherosclerosis;
- cancer;
- diabetes mellitus type 2;
- Alzheimer's disease;
- osteoarthritis;
- rheumatoid arthritis;
- osteoporosis;
- Parkinson's disease;
- multiple sclerosis;
- prostatitis.
Most often people refer to these ailments as "terrible", but this is not the whole list. There are diseases that some have never even heard of.
Degenerative-dystrophic diseases of the joints
The basis of the degenerative-dystrophic disease of osteoarthritis is the degeneration of the cartilage of the joint, as a result, with subsequent pathological changes in the epiphyseal bone tissue.
Osteoarthritis is the most common joint disease, affecting 10-12% of people, the number only increases with age. The hip or knee joints are more commonly affected in both women and men. Degenerative diseases - osteoarthritis is divided into primary and secondary.
Primary arthrosis accounts for 40% of the total number of diseases,the degenerative process is triggered as a result of heavy physical exertion, with a sharp increase in body weight, with age-related changes.
Secondary arthrosis account for 60% of the total. Often occur as a result of mechanical injuries, intra-articular fractures, with congenital dysplasia, after infectious joint diseases, with aseptic necrosis.
In general, arthrosis is divided into primary and secondary purely conditionally, since they are based on the same pathogenic factors, which may have a different combination. Most often, it is not possible to determine which factor has become the main one and which one has become secondary.
After degenerative changes, joint surfaces press against each other excessively when in contact. As a result, in order to reduce the mechanical impact, osteophytes grow. The pathological process progresses, the joints become more and more deformed, the functions of the muscular-ligamentous apparatus are disrupted. Movement becomes limited, contracture develops.
Deforming coxarthrosis. Deforming gonarthrosis
Degenerative joint diseases coxarthrosis and gonarthrosis are quite common.
The first place in the frequency of occurrence is occupied by coxarthrosis - deformity of the hip joint. Disease leads first to disability, and later to disability. The disease often occurs between 35 and 40 years of age. Women suffer from this more often than men. Symptoms appear gradually, depending on the age, weight of the patient, physical activity of the person. The initial stages do not have pronouncedsymptoms. Sometimes fatigue is felt in a standing position and when walking or when carrying weights. As the degenerative changes progress, the pain increases. Completely disappear only in a state of rest, in a dream. At the slightest load, they resume. When the form is running, the pain is constant, it can intensify at night.
Gonarthrosis takes the second place - 50% among diseases of the knee joints. It proceeds easier than coxarthrosis. For many, the process is suspended at stage 1. Even neglected cases rarely lead to loss of performance.
There are 4 forms of gonarthrosis:
- lesions of the internal sections of the knee joint;
- predominant lesions of the external departments;
- arthritis of the patellofemoral joints;
- damage to all articular sections.
Osteochondrosis of the spine
Degenerative diseases of the spine: osteochondrosis, spondylosis, spondylarthrosis.
With osteochondrosis, degenerative processes begin in the intervertebral discs in the nucleus pulposus. With spondylosis, the bodies of adjacent vertebrae are involved in the process. In spondylarthrosis, the intervertebral joints are affected. Degenerative-dystrophic diseases of the spine are very dangerous and poorly treatable. The degrees of pathology are determined by the functional and morphological features of the discs.
People over 50 suffer from these disorders in 90% of cases. Recently, there has been a trend towards rejuvenation of spinal diseases, they occur even in young patients.age 17-20 years. More often, osteochondrosis is observed in people who are engaged in excessive physical labor.
Clinical manifestations depend on the localization of the expressed processes and may be neurological, static, vegetative disorders.
Degenerative diseases of the nervous system
Degenerative diseases of the nervous system unite a large group. All diseases are characterized by damage to groups of neurons that connect the body with certain external and internal factors. This happens as a result of violations of intracellular processes, often this is due to genetic defects.
Many degenerative diseases are manifested by limited or diffuse atrophy of the brain, in certain structures there is a microscopic decrease in neurons. In some cases, only a violation in the functions of cells occurs, their death does not occur, brain atrophy does not develop (essential tremor, idiopathic dystonia).
The vast majority of degenerative diseases have a long period of latent development, but a steadily progressive form.
Degenerative diseases of the CNS are classified according to clinical manifestations and reflect the involvement of certain structures of the nervous system. Stand out:
- Diseases with manifestations of extrapyramidal syndromes (Huntington's disease, tremor, Parkinson's disease).
- Diseases that exhibit cerebellar ataxia (spinocerebellar degeneration).
- Diseases with lesionsmotor neurons (amyotrophic lateral sclerosis).
- Diseases with dementia (Pick's disease, Alzheimer's disease).
Alzheimer's disease
Neuro-degenerative diseases with manifestations of dementia are more likely to occur in old age. The most common is Alzheimer's disease. It progresses in people over 80 years of age. In 15% of cases, the disease is familial. Develops over 10-15 years.
Neurons begin to be damaged in the associative areas of the parietal, temporal and frontal cortex, while the auditory, visual and somatosensory areas remain unaffected. In addition to the disappearance of neurons, important characteristics include deposits in senile plaques of amyloid, as well as thickening and thickening of the neurofibrillary structures of degenerating and preserved neurons, they contain tauprotein. In all older people, such changes occur in small quantities, but in Alzheimer's disease they are more pronounced. There were also cases when the clinic resembled the course of dementia, but many plaques were not observed.
The atrophied area has a reduced blood supply, this may be an adaptation to the disappearance of neurons. This disease cannot be a consequence of atherosclerosis.
Parkinson's disease
Parkinson's disease is also known as shaking paralysis. This degenerative brain disease progresses slowly, while selectively affecting dopaminergic neurons, manifested by a combination of rigidity withakinesia, postural instability and rest tremor. The cause of the disease is still unclear. There is a version that the disease is hereditary.
The prevalence of the disease is wide and reaches 1 in 100 in people over 65.
The disease appears gradually. The first manifestations are trembling of the limbs, sometimes changes in gait, stiffness. First, patients notice pain in the back and limbs. Symptoms are unilateral at first, then the other side is involved.
Progression of Parkinson's disease
The main manifestation of the disease is akinesia or impoverishment, slowing down of movements. The face becomes mask-like over time (hypomymia). Blinking is rare, so the look seems piercing. Friendly movements disappear (waves of hands when walking). Fine finger movements are disturbed. The patient hardly changes his position, gets up from a chair or turns in his sleep. Speech is monotonous and muffled. Steps become shuffling, short. The main manifestation of parkinsonism is a tremor of the hands, lips, jaw, head, which occurs at rest. The tremor may be affected by the patient's emotions and other movements.
In the later stages, mobility is sharply limited, the ability to balance is lost. Many patients develop mental disorders, but only a few develop dementia.
The rate of progression of the disease is different, it can be for many years. By the end of life, patients are completely immobilized, swallowing is difficult, there is a risk of aspiration. As a result, death most often occurs from bronchopneumonia.
Essential tremor
A degenerative disease characterized by benign trembling, not to be confused with Parkinson's disease. Hand tremor occurs when moving or holding a pose. In 60%, the disease is hereditary in nature, it manifests itself most often over the age of 60 years. It is believed that the cause of hyperkinesis is a violation between the cerebellum and the brainstem nuclei.
Tremor can be aggravated by fatigue, excitement, drinking coffee, and certain drugs. It happens that the tremor involves movements of the head like “no-no” or “yes-yes”, legs, tongue, lips, vocal cords, torso can be connected. Over time, the amplitude of the tremor increases, and this interferes with the normal quality of life.
Life expectancy does not suffer, neurological symptoms are absent, intellectual functions are preserved.
