And whether you know...
September 26, 2011
Parkinson's illness (parkinsonism, trembling paralysis) is a degenerative disease of a brain, caused by gradual dying off of the cells containing dopamine which are located in basal gangliya of deep departments of a brain ("black substance"). Its manifestations – constraint of movements, problems with walking, muscle tension, trembling (tremor) of hands and legs.
Symptoms of an illness of Parkinson at the beginning of the 19th century for the first time were described by the doctor James Parkinson in "The essay about trembling paralysis" thanks to what the disease and received a name of the scientist. This illness affected such famous people in due time as the Pope John Paul II, the actor Michael Jay Fox, the boxer Muhammad Ali, the Spanish dictator Franco, the artist Salvador Dalí, and some other.
Physicians conduct many years attempts to decide how there is this illness and how to slow down its development. For today Parkinson's illness is the most widespread disease among people of advanced age (after Alzheimer's disease), is shown usually in 55-65 years, and quickly enough progresses. However also the course of a disease at earlier age (till 40 flyings) – the juvenile parkinsonism most often caused by genetic predisposition meets.
At men symptoms of an illness of Parkinson occur more often than at women. Distinguish parkinsonism primary and secondary. Primary parkinsonism (idiopathic, Parkinson's illness) is caused by heredity and makes up to 80% of displays of this disease. Secondary (Parkinson's syndrome, can be medicinal, vascular, etc.) it is shown against other diseases. At this stage complications of an illness of Parkinson develop more often.
Physicians allocate three basic reasons of disturbance of production of the dopamines necessary for normal physical activity and consequently developing of an illness of Parkinson. It is genetic predisposition, aging and influence of some substances and toxins. Parkinson's syndrome most often develops against such diseases as tumors, encephalitis, the postponed craniocereberal injuries, brain injuries, the atherosclerosis of brain arteries leading to strokes, drug addiction, a poisoning with cyanides, ethanol, manganese, excess reception of some drugs (neuroleptics), hereditary diseases of TsNS.
Symptoms of an illness of Parkinson
The main symptoms of an illness of Parkinson is the following:
- constraint, slowness of movements (bradykinesia) which is usually shown from the right hand and gradually take all body. Constraint is usually shown consistently in 5 stages. At first symptoms of parkinsonism are shown in one half of a body, then – in both parts, difficulties appear then at deduction of a pose when walking and standing. Later there comes restriction of a physical activity, and then and a prikovannost to a wheelchair or a bed;
- the raised tone of all muscles that leads to the fact that legs and hands are bent in joints, the back begins to stoop, the head bends forward;
- trembling of hands, legs and the head, even then the person does not move (a rest tremor) which passes during the movement. Of it it is characteristic the specific movements by fingers – "rolling balls" or "the account of coins";
- change of gait which becomes shuffling disappearance of control over a pose, is lost the center of gravity that can lead to loss of balance and falling;
- muffled speech;
- slowness of attention, thinking;
- excess salivation because of disturbance of mobility of muscles of a throat;
- disturbance of mimic activity (gipomimiya), rare blinking;
- disturbance of activity of a bladder;
- depression (including depressions at advanced age), apathy, loss of interest in world around;
- vegetative disturbances, frequent locks, impotence, decrease in sense of smell, strengthening of fat content of skin, perspiration.
It is important to notice that Parkinson's illness is the progressing disease, and rather often at an initial stage the illness has a latent current.
At a disease of parkinsonism of a problem there is a rising about beds and chairs, revolutions in a bed, difficulties during the toothbrushing and commission of simple household affairs appear. Sometimes slow gait is replaced by fast run with which the patient cannot cope, will not face an obstacle yet or will fall. The speech of the patient becomes monotonous, without modulations.
Diagnosis of an illness of Parkinson
Important at detection of the first symptoms of a disease to see a doctor. The doctor, at diagnosis of an illness of Parkinson, first of all defines disease type – primary or secondary. Also it becomes clear whether there are factors leading to development of secondary parkinsonism – atherosclerosis of vessels, craniocereberal injuries, work on harmful production, drug intake and others. Neurologic survey then typical treatment is appointed and if the patient well responds to it, then it indicates Parkinson's illness is appointed. Also the electromyography which allows to define the trembling reason, and also to exclude muscular diseases is carried out.
If symptoms of an illness of Parkinson are shown is not characteristic, and the effect of treatment is minimum, such researches as a computer and magnetic and resonant tomography of a brain are conducted.
Treatment of an illness of Parkinson
Treatment of a disease is directed to attempts to suspend dying off of the cells containing dopamine in a brain, and on reduction of unpleasant displays of an illness. Timely treatment, reducing disease symptoms, can help to keep social and professional activity of the patient for a long time. The drugs appointed at Parkinson's illness do not cure of an illness, but can facilitate considerably its course and reduce symptoms. The appointed treatment is carried out all life of the patient for this purpose to avoid resuming of displays of parkinsonism. Medicinal therapy promotes maintenance of motive functions.
As medicinal therapy which is directed to completion of deficit of dopamine levodopa drugs (the NAC, Madoparum), and for a zatormazhivaniye of disease – neyroprotektny therapy – drugs of an amantadin (Midantanum), monoaminooxidase inhibitors (selegilin), inhibitors catechol-au-methyltransferase (entakapon, tolkapon), anticholinergics (Akinetonum, Tropacinum, Dinezinum, Cyclodolum) and agonists of dopamine receptors (pergolid, Apomorphinum, lizurid, Mirapeks, Pronoran), vitamin E reception are used. However all these drugs have unpleasant side effects, to emergence of nausea, vomiting, hallucinations.
Medical drugs begin to appoint as it is possible later when it is observed the motive restrictions stirring a message normal life. To these drugs there is an accustoming, and for achievement of the necessary medical effect it is necessary to accept high doses of medicine that leads to negative side effects. Therefore treatment of an illness of Parkinson, begin usually with softer drugs, and try to pass to high doses only on an urgent need. For example, drugs of a levodopa are appointed in the last turn, despite their high performance.
Recently options of neurosurgical treatment of parkinsonism, by change to the patient of the cells producing dopamine are actively studied. 2 types of surgical intervention – operation on stimulation of deep structures of a brain (implantation of electrodes with their subsequent electrostimulation) and stereotaxic operations in the field of subcrustal kernels are applied. Carrying out similar operations promote reduction of displays of an illness, to decrease in muscular rigidity, constraint, and to reduction of dosages of the accepted medicines. All this leads to improvement of social activity of the patient.
The choice of a method of treatment depends on disease severity and a state of health, and is carried out only by the doctor after full diagnosis of an illness of Parkinson is carried out. Also the doctor can appoint, in addition to reception of medicines, physical exercises, observance of a diet, medical massage, physical therapy. Reception of vitamin complexes, especially vitamins E and With, the nootrop, drugs improving blood circulation and other fortifying means is also useful. Electroconvulsive therapy, because of difficulties of use, is used in case of emergency, and has the expressed antiparkinsonichesky effect, reducing rigidity of a body and constraint of movements, and also possessing antidepressive properties.
Complications of an illness of Parkinson
It is necessary to notice that progressing, Parkinson's illness, leads to motive and emotional disturbances that in turn is followed by restrictions of social adaptation, to narrowing of a circle of contacts, decrease in movement, difficulties in performance of household affairs. The lack of coordination leads to falling which are followed by injuries, an obezdvizhennost – pneumonia therefore the death a thicket of all occurs at the last, fifth stage of an illness.