It is very important to recognize the first signs of Parkinson's disease. This is a serious, slowly progressing neurological disease characteristic of older people. Unfortunately, it is incurable, however, there is therapy, adherence to which can significantly alleviate the symptoms.
What are its premises? What symptoms indicate the development of the disease? How to diagnose it and what are the basic principles of treatment? This will be discussed now.
Etiology
Before you consider the first signs of Parkinson's disease, you need to study the causes of its development. At the moment, unfortunately, they remain unclear. Etiological factors include genetic predisposition, aging, and environmental factors.
These assumptions are logical. Pathomorphologically, aging is accompanied by a decrease in the number of neurons of the substantia nigra and the presence of Levi bodies in them. Also, this process is characterized by neurochemical changes in the striatum. The content of the tyrosine hydroxylase enzyme 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 with Parkinson's disease is several times higher than with normal aging.
Also, approximately 15% of patients have a family history of this disease. But the genes that are 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 heavy metal salts, 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. This is thought to be related to the dopamine-stimulating effect that nicotine exerts. They also say that the regular use of caffeine protects from the development of this ailment.
Early symptoms
Now you should study the first signs of Parkinson's disease. Many symptoms are not related to movement. Non-motor, "invisible" signs are very common, and they often affect life more than the more obvious difficulties associated with movement. They include:
- Sleep disorders.
- Constipation.
- Violation of smell.
- Frivolity and memory loss.
- Depression and anxiety.
- Increased sweating.
- Urination disorder.
- Pain in the extremities (at first there is only one, can 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, the shoulder-shoulder 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 should be noted that its main manifestation is the so-called Parkinson's syndrome. Its symptoms can be identified in the following list:
- Slow motion of all movements.
- Instability when walking.
- Stiffness of the muscles, also called stiffness.
- Exhaustion of repeated rapid movements in the legs and arms.
- Trembling legs and arms, very rarely - the head. It is especially pronounced in the resting position.
- Shortened step.
- Shuffling while walking and suddenly freezing in her process.
- Lack of hand movements when walking, referred to as friendly
- Trampling on the spot.
It should be noted that at first the symptoms appear only on one side of the body, but gradually they become bilateral in nature. 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 is progressing - movements are becoming more and more slowed down, signs are becoming more distinct, although they fluctuate throughout the day.
Tremor
Since we are talking about how Parkinson's disease manifests itself, this symptom needs to be addressed. Tremor is trembling, it is easiest to identify it, because it is obvious.
It appears when the patient is at rest, however, other types of symptom are also possible (intentional, for example, or postural).
The frequency is approximately 4-6 Hz (movements per second). As a rule, tremor begins in the distal part of one arm, and as the disease progresses, the disease spreads to the opposite arm, and also to the legs.
A specific symptom is multidirectional finger movements. Visually, it looks like rolling pills or counting coins. In rare cases, there is a trembling of the jaw, tongue, eyelids or head of the type "no-no" or "yes-yes."
It may be that the tremor covers the whole body. Trembling is always amplified during moments of excitement, but practically does not occur during the patient's arbitrary movements or sleep.
It should be noted that in contrast to cerebellar tremor, which makes itself felt only when moving, the symptom of Parkinson's disease, on the contrary, decreases or disappears altogether when a person shows physical activity.
Hypokinesia
Discussing the first symptoms and signs of Parkinson's disease, you need to talk about this phenomenon. Hypokinesia is called a decrease in spontaneous motor activity. A person can freeze, and remain motionless and stiff for several hours.
The ability to active movements returns after a certain delay, but their pace is still low, and this is called bradykinesia.
The patient moves in small steps, while his feet are parallel to each other. This phenomenon is called a puppet walk. A mask-like face (amimia) is also observed. You may notice that the patient rarely blinks, and characterize the gaze as frozen. All manifestations of emotions arise belatedly.
The expressiveness of speech also disappears in a person - it becomes monotonous, literally fades out. In addition, micrography is manifested, 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 with a diagnosis of Parkinson's disease do not have sweeping hand movements when walking and forehead wrinkling when looking up, and when the fingers are clenched into a fist, the brush does not bend.
In general, all patient actions resemble automatic ones. And it is very difficult for people with this diagnosis to perform several targeted movements at the same time.
Muscle stiffness
This concept denotes a uniform increase in muscle tone that occurs according to the plastic type. The symptom is manifested by hardening of the extremities during extension and flexion. This is often referred to as plastic wax flexibility.
If rigidity predominates in a specific muscle group, then a characteristic pose of the supplicant is formed. It can be recognized by the following signs:
- Slouch.
- Legs bent at the knee and hip joints.
- Head tilted forward.
- Hands pressed to the body in a bent position.
If a person tries to perform flexion and extensor movements, then he feels the steppedness of tension in the muscles and a certain discontinuity.
As a result, the tendency of the limbs to return to their original position after the movement is performed is disrupted. If, for example, a person abruptly bends the foot from the back, then for a while it will retain the position that was given to it. This is also called the Westphalian 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), retro-pulsation and lateropulse also make themselves felt. How is this manifested? The person who started the movement shifts the position of the center of gravity. One gets the impression that the body seems to be ahead of the legs. Because of this, the patient may lose stability and fall.
Many patients still have the so-called paradoxical kinesia. What are they manifested in? In the disappearance for several hours of the characteristic symptoms 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 by attention, talking about how Parkinson's disease manifests itself. And we are talking about mental and autonomic disorders. Ailment, in addition to violations of the motor sphere, they also accompany.
Metabolism is often impaired. As a result, a person is either depleted (this is called cachexia), or begins to suffer from obesity. There are also secretory disorders, manifested by excessive sweating, increased salivation and greasy skin (especially the face).
What about mental disorders? In the early stages of Parkinson's disease, they rarely occur. This is already becoming a complication. Because most often mental disorders arise as a result of taking anti-Parkinsonian 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 disorientation of orientation, as well as insomnia, confusion and fear. Slightly less often, patients suffer 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, uninitiated, lethargic, and often ask the same questions, repeating themselves in their words.
Diagnostic Principles
It was described above how Parkinson's disease begins. What about the diagnosis? In fact, it does not cause difficulties. To determine the disease, hypokinesia combined with one of the previously listed symptoms is sufficient.
Methods to establish the correct diagnosis at the beginning of the development of the disease also exist in neurology. Parkinson's disease at an early stage can be determined through differential diagnosis and the identification of postural reflexes.
Everything happens in two stages. First you need to exclude the processes and conditions in which symptoms similar to Parkinson's disease are observed. It is important! After all, the notorious Parkinson's syndrome is inherent in the following conditions:
- Tremor resulting from damage to the cerebellum.
- Apraxia of walking, caused by brain tumors or normotensive hydrocephalus.
- Muscle hypertonicity, also referred to as rigid human syndrome.
- Psychomotor inhibition, which can manifest itself as hypersomnia, hysteria, stupor, or depression.
According to statistics, in 80% of cases, Parkinsonism provokes lesions of the nigrostriatal system. It can be post-traumatic, vascular, postencephalitic, drug and toxic.
Diagnostic Methods
They need to be studied before considering which drugs to take in Parkinson's disease.
First, a neurologist performs an external examination. Then it forms an individual history. After this, the patient is invited to take a test - write a small text on a sheet in order to study his handwriting. When the lines are shifted up and the letters are small, the development of a degenerative process is diagnosed.
Another doctor may ask the patient to bring his arms down and spread, tap his foot on the floor. Slowed range of motion is an occasion to suspect a neurological pathology.
After this, the following events are appointed:
- Identification olfactory test.
- Submission of an analysis to assess the state of hormones produced by the thyroid gland.
- Levopod test, which involves a biopsy of the salivary glands. Thus, it can be determined whether a pathological protein is present in the patient’s biomaterial.
- Submitting a blood test to determine cholesterol and glucose and urine, in order to identify the level of creatinine present in it.
- Electroencephalography, MRI, CT, positron emission tomography.
- Intracranial ultrasound dopplerography.
- Rheoencephalography.
Based on the results of all procedures, it seems possible to establish the correct diagnosis, formalize disability in Parkinson's disease, and also begin competent treatment.
Therapy
In order to stop twitching in the calves and hand tremors, the use of such drugs is prescribed:
- Medicines belonging to the group of adrenergic antagonists. However, they are prohibited if a person suffers from diabetes and heart pathologies.
- Primidon is an anticonvulsant drug that must be drunk before bedtime in an amount of 25 mg.
- Benzodiazepines. But they are prescribed if other drugs have been ineffective. Most often, patients are prescribed such well-known drugs as “Clonazepam” and “Xanax”.
If conservative methods are useless, then the patient is prescribed stereotactic thalamotomy. This is the name of a surgical operation that eliminates the 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 in which they perform such operations qualitatively. There is another option - treatment abroad, for example, in Israel, where medicine is very well developed.
Also, one must not forget about the effectiveness of exercise therapy for Parkinson's disease. This is a very effective method to help overcome the syndrome. After all, physiotherapy exercises are aimed at improving the functioning of the cardiovascular, motor, digestive and respiratory systems. And also, regularly doing exercise therapy, you can reduce anxiety and minimize the likelihood of depression.
With parkinsonism, physical education helps prolong the patient's physical activity for many years. If he shows zeal, then he will also be able to stop movement disorders in the future.
However, she can be dealt with only after consulting a doctor if he approves 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 studied disease, but also for the body as a whole.