It is very important to recognize the early signs of Parkinson's disease. This is a serious, slowly progressive neurological disease that is common in older people. Unfortunately, it is incurable, however, there is a therapy that can significantly alleviate the symptoms.
What are its prerequisites? What symptoms indicate the development of the disease? How to diagnose it and what are the basic principles of treatment? This is what we will talk about now.
Etiology
Before considering the first signs of Parkinson's disease, you need to study the causes of its development. At the moment, unfortunately, they remain unexplained. Etiological factors include genetic predisposition, body aging, and exposure to environmental factors.
These assumptions are logical. Pathomorphologicallyaging is accompanied by a decrease in the number of substantia nigra neurons and the presence of Lewy bodies in them. Also, this process is characterized by neurochemical changes in the striatum. The content of the enzyme tyrosine hydroxylase decreases, the amount of dopamine and directly dopamine receptors decreases.
Using positron emission tomography, it was possible to prove that the rate at which neurons degenerate in Parkinson's disease is several times higher than in normal aging.
Also, approximately 15% of patients have a family history of the disease. But the genes responsible for its development are still not identified.
It is also assumed that parkinson-like manifestations are a consequence of negative factors affecting a person from the outside - these can be s alts of heavy metals, herbicides, pesticides. Risk factors also include living near quarries and industrial enterprises, as well as in rural areas.
Interestingly, the risk of developing Parkinson's disease in people who smoke is three times lower than in people who do not use nicotine. It is assumed that this is due to the dopamine-stimulating effect that nicotine has. They also say that regular use of caffeine protects against the development of this disease.
Early symptoms
Now you should study the first signs of Parkinson's disease. Many of the symptoms have nothing to do with movement. Non-motor, "invisible" signs are very common, and they often affect life more tangibly than more obvious ones.movement difficulties. They include:
- Sleep disorders.
- Constipation.
- Violation of smell.
- Lidness and memory loss.
- Depression and anxiety.
- Excessive sweating.
- Urinary disorder.
- Pain in the limbs (only one at first, may spread to any part of the body).
- Sexual dysfunction.
- Tingling sensation.
It should be noted that at first the wrong diagnosis is often made, namely, humeroscapular periarthritis, the main symptom of which is pain and tension, manifested in the muscles of the back and arms.
Listing the first signs of Parkinson's disease, it must be noted that the so-called Parkinson's syndrome is considered its main manifestation. Its symptoms can be listed as follows:
- Slowness of all movements.
- Unsteady when walking.
- Muscle stiffness, also called stiffness.
- Fatigue from repetitive fast movements in the legs and arms.
- Trembling of the legs and arms, very rarely of the head. It is especially pronounced in the resting position.
- Short step.
- Shuffling when walking and sudden freezing in the process.
- Lack of hand movements when walking, called friendly
- Treading the spot.
It should be noted that at first the symptoms appear only on one side of the body, but gradually they becomebilateral character. Signs remain most pronounced on the side on which they appeared at the very beginning of the development of diseases.
On the other side of the body the symptoms very often do not become as severe. But the disease progresses - the movements become more and more slow, the signs become distinct, although they fluctuate throughout the day.
Tremor
Since we are talking about how Parkinson's disease manifests itself, we need to pay attention to this symptom. Tremor is trembling and is the easiest to identify because it is obvious.
Occurs when the patient is at rest, but other types of symptom (intentional, for example, or postural) are still possible.
The frequency is approximately 4-6 Hz (movements per second). As a rule, a tremor begins in the distal part of one arm, and as the disease progresses, it spreads to the opposite arm, and also to the legs.
Specific symptom - multidirectional movements of the fingers. Visually, it resembles rolling pills or counting coins. In rare cases, there is a trembling of the jaw, tongue, eyelids, or head in the “no-no” or “yes-yes” type.
It may be that the tremor will cover the entire body. Trembling is always increased during moments of excitement, but practically does not appear during the patient's voluntary movements or sleep.
It must be noted that, unlike cerebellar tremor, which makes itself felt only when moving, a symptom of Parkinson's disease, on the contrary, decreases or disappears altogether when a person shows physicalactivity.
Hypokinesia
Discussing the first symptoms and signs of Parkinson's disease, you need to talk about this phenomenon. Hypokinesia is a decrease in spontaneous motor activity. A person can freeze, and remain motionless and stiff for several hours.
Returns the ability to active movements after a certain delay, but their pace is still slow, and this is called bradykinesia.
The patient moves in small steps, while his feet are parallel to each other. This phenomenon is called the puppet walk. There is also a mask-like face (amimia). It can be noted that the patient rarely blinks, and the look is characterized as frozen. All manifestations of emotions occur with a delay.
Even a person loses the expressiveness of speech - it becomes monotonous, literally fades. In addition, micrography appears, which is characterized by a decrease in handwriting. This occurs for a logical reason - due to a decrease in the amplitude of movements.
Also, people diagnosed with Parkinson's disease do not have sweeping arm movements when walking and wrinkling of the forehead when looking up, and when clenching the fingers into a fist, the hand does not extend.
In general, all the actions of the patient resemble automatic ones. It is also very difficult for people with this diagnosis to perform several purposeful movements at the same time.
Muscle stiffness
This concept refers to a uniform increase in muscle tone, which occurs according to the plastic type. The symptom is manifested by stiffening of the limbs during extension and flexion. This is often referred to as plastic wax flexibility.
If rigidity prevails in a particular muscle group, then a characteristic supplicant posture is formed. It can be recognized by the following features:
- Slouching.
- Bent legs at the knee and hip joints.
- Head tilted forward.
- Hands pressed to the body in a half-bent position.
If a person tries to perform flexion and extension movements, then he feels a gradual tension in the muscles and some discontinuity.
As a result, the tendency of the limbs to return to their original position after the movement is violated. If, for example, a person sharply bends the foot from the back, then it will temporarily retain the position that was given to it. This is also called the Westphal phenomenon.
Postural instability
This is another manifestation of Parkinson's disease. The first symptoms and signs were discussed above, but postural instability is characteristic of the later stages of the disease.
You can learn about this manifestation by the difficulties experienced by a person at the moment of overcoming the inertia of movement and rest. It is very difficult for him to start moving and then stop him.
Propulsion (pushing forward), retropulsion and lateropulsion also makes itself felt. How does it manifest itself? The person who started the movement shifts the position of the center of gravity. One gets the impression that the torso seems to be ahead of the legs. This can cause the patient to lose balance and fall.
Many patients still have so-called paradoxical kinesias. In what way do they appear? In the disappearance for several hours of symptoms characteristic of the disease. A person simply begins to move freely, does not experience any difficulties in performing certain actions.
These kinesias occur as a result of strong emotional experiences or sometimes after sleep. Unfortunately, after a couple of hours, the symptoms again make themselves felt.
Disorders
Another characteristic symptom should be noted with attention, talking about how Parkinson's disease manifests itself. And we are talking about mental and vegetative disorders. The disease, in addition to violations of the motor sphere, is also accompanied by them.
The metabolism is often disturbed. As a result, a person either becomes emaciated (this is called cachexia) or becomes obese. Secretory disorders are also observed, manifested by excessive sweating, increased salivation and greasiness of the skin (especially the face).
What about mental disorders? They rarely occur in the early stages of Parkinson's disease. This is already becoming a complication. Because most often mental disorders occur as a result of taking antiparkinsonian drugs. Although in some cases they are caused by the disease itself.
Most often, patients suffer from psychosis. It is characterized by a hallucinatory-paranoid state, accompanied by a violation of orientation, as well as insomnia, confusion and fear. Slightly less patientssuffer from dementia. The most common disorders are depression, pathological fatigue and sleep disorders.
You can also notice that people with Parkinson's disease are annoying, lack of initiative, lethargic, and also often ask the same questions, repeating themselves in their words.
Principles of diagnosis
The above described how Parkinson's disease begins. What about diagnostics? Actually, it doesn't cause problems. To determine the disease, hypokinesia, combined with one of the symptoms listed above, is enough.
Methods to establish the correct diagnosis at the beginning of the development of the disease also exist in neurology. Early detection of Parkinson's disease can be achieved through differential diagnosis and detection of postural reflexes.
Everything happens in two stages. First you need to exclude processes and conditions in which symptoms similar to Parkinson's disease are observed. It is important! After all, the notorious parkinsonism syndrome is inherent in the following conditions:
- Tremor due to damage to the cerebellum.
- Apraxia of walking caused by brain tumors or normotensive hydrocephalus.
- Muscular hypertonicity, also called rigid man syndrome.
- Psychomotor retardation, which can manifest as hypersomnia, hysteria, stupor or depression.
According to statistics, in 80% of cases, parkinsonism is provoked by lesions of the nigrostriatal system. He can bepost-traumatic, vascular, post-encephalitic, medicinal and toxic.
Diagnostic Methods
These should be studied before considering which drugs to take for Parkinson's disease.
First, a neurologist conducts an external examination. Then he formed an individual anamnesis. After that, the patient is invited to take a test - write a small text on a piece of paper in order to study his handwriting. When the lines are shifted upwards and the letters are small, the development of a degenerative process is diagnosed.
The doctor may also ask the patient to bring his hands together and apart, tap his foot on the floor. A slow range of motion is a reason to suspect a neurological pathology.
After that, the following events are scheduled:
- Identification olfactory test.
- Surveying an analysis to assess the state of hormones produced by the thyroid gland.
- Levopod test, which involves a biopsy of the salivary glands. So you can find out if a pathological protein is present in the patient's biomaterial.
- Handling a blood test to determine cholesterol and glucose and urine, in order to determine the level of creatinine present in it.
- Electroencephalography, MRI, CT, positron emission tomography.
- Intracranial Doppler Ultrasound.
- Rheoencephalography.
Following the results of all procedures, it is possible to establish the correct diagnosis, apply for disability in Parkinson's disease, and also begin competent treatment.
Therapy
In order to stop twitching in the calves and tremor of the hands, the following drugs are prescribed:
- Medicines belonging to the group of adrenoreceptor antagonists. However, they are prohibited if a person suffers from diabetes and heart pathologies.
- Primidon is an anticonvulsant drug to be taken at bedtime in an amount of 25 mg.
- Benzodiazepines. But they are prescribed in the event that other drugs have been ineffective. Most often, patients are prescribed such well-known drugs as Clonazepam and Xanax.
If conservative methods fail, the patient is prescribed a stereotaxic thalamotomy. This is the name of a surgical operation that allows you to eliminate symptoms, as well as restore motor activity.
Where is Parkinson's disease treated with such a radical method? Fortunately, in Russia there are quite a few public and private medical centers that perform such operations with high quality. There is another option - treatment abroad, for example, in Israel, where medicine is very well developed.
Also, we must not forget about the effectiveness of exercise therapy in Parkinson's disease. This is a very effective method to help overcome the syndrome. After all, physical therapy is aimed at improving the functioning of the cardiovascular, motor, digestive and respiratory systems. In addition, regular exercise therapy can reduce anxiety and minimize the likelihood of depression.
Physical education helps with parkinsonismprolong the patient's physical activity for many years. If he is diligent, he will also be able to stop movement disorders in the future.
However, it can only be practiced after consulting a doctor, if he approves of this idea. It is important to do exercises under the supervision of a specialist, because only he can develop a program that implements all types of loads - strength exercises, aerobic and stretching (stretching). This is useful not only for the disease under study, but also for the body as a whole.
