Parkinson's disease is a neurodegenerative pathology of the brain with sexual preference: it occurs in adult and older women less often than in men. However, the reduced incidence does not mean that the disease is so rare. Every year the number of patients is growing, and the age of the first signs of Parkinson's in women has decreased from 50-60 years to 35-40. This is due to the accumulation of genetic mutations, environmental pollution and the fact that women in recent decades have been working on an equal basis with men in hazardous industries.

Despite the fact that a sharp decrease in the level of the neurotransmitter dopamine in the substantia nigra of the brain makes both sexes suffer, each of them has its own characteristics of symptoms, course and treatment of parkinsonism.

Until now, scientists have not been able to establish exactly why the process of dopamine production is disrupted in certain people at a certain age.

  • skull trauma;
  • brain tumors;
  • transferred infections, encephalitis;
  • vascular pathology;
  • taking medications that affect the central nervous system;
  • poisoning with pesticides through constant contact;
  • poisoning with toxins;
  • heavy metal salts.

An important role is played by hereditary predisposition. If close relatives (parents or grandmothers, grandfathers) showed symptoms, then the chance of its development in descendants greatly increases.

The reasons are the same for both sexes, however the ladies have both advantages and disadvantages. The production of estrogens helps maintain the required level of dopamine, so women with Parkinson's are less common than men, their disease develops, as a rule, more slowly, after menopause. However, there is a flip side of the coin - the reasons provoking the development of pathology in the beautiful half of humanity:

  • early menopause;
  • 3 or more pregnancies;
  • ovarian dysfunction;
  • hysterectomy.

Initial signs

Doctors rarely succeed in making the correct diagnosis when women first visit.

Signs of Parkinson's disease in women at an early stage do not manifest themselves clearly and coincide with a number of other diseases.

At the initial stage, patients present with five typical complaints:

  1. Disruption of the digestive tract, frequent constipation.
  2. Change of voice for no apparent reason.
  3. Loss or sharp weakening of the sense of smell.
  4. Developed stoop.
  5. Depression for no apparent reason.

In addition to this, common to all, a set of at first glance frivolous signs, women have three special symptoms of Parkinson's disease at the initial stage:

  1. Disturbed restful sleep. Active change of position during sleep, screams, sudden uncontrolled movements of the limbs in a state of nap or deep sleep.
  2. Pain in the shoulders, upper spine, arising suddenly and for no reason.
  3. Increased sweating, increased oiliness of the skin, hair. An increase in the amount of saliva produced.

The first signs of Parkinson's disease do not appear complex in adult women, most often gradually replaced by others over time. Because of this, treatment is rarely possible to start on time, before the onset of the development of the main complex of the disease.

Only experienced neurologists are able to generalize the manifestations, draw the correct conclusions and begin treatment of the early stage of Parkinson's in women.

Neurological symptoms of Parkinson's disease in women

The progression of the disease leads to a dopamine deficiency of up to 80% and the manifestation of a whole complex of characteristic symptoms of Parkinson's disease in women at an early (1) stage:

Not obvious phenomena and disorders become signals of Parkinson's disease.

Tremor. Tremors in the limbs do not always indicate parkinsonism, especially in old age. It can occur due to hypothermia, excessive physical exertion, emotional overexcitation. However, if your hands are trembling in a state of complete rest, you should consult a doctor, since this symptom is characteristic of parkinsonism in women.

Decreased power of smell, taste... Favorite perfume smells weaker, and food has to be salted more - all this is a reason to see a doctor.

Change in how you feel during your period... An exacerbation of Parkinson's symptoms during menstruation can be a sign of the development of the disease in women 35-45 years old. At the same time, the cycle often gets lost, it becomes irregular.

An abrupt change in handwriting... It becomes incomprehensible, shallow, clumsy. With age and without daily training, everyone's handwriting deteriorates, due to the weakening of the ability to fine motor skills, loss of skill, deterioration of vision. But under the influence of these factors, the changes are gradual. And with a disease of the central nervous system - sharp.

Dizziness with a sharp rise. If earlier such a condition was uncharacteristic for a person, then this indicates painful changes in the body.

Sedentary face... Lack of blinking, changes in facial expression in a resting situation. In emotional situations, facial expressions become insufficient.

Decrease the volume of your voice... Moreover, it often seems to a person that his voice has not changed, and those around him hear him worse. Articulation changes. If a person began to open his mouth wider, try to pronounce the words more clearly, but at the same time his speech did not become more intelligible - this may be one of the early symptoms of the development of parkinsonism.

Muscular system symptoms

Sudden stoop, which was not previously characteristic. If there have been no recent injuries or physical overstrain of the upper spine, shoulder girdle, then it is necessary to consult a neurologist.

Stiffness in the shoulder girdle, constant sudden pain in the neck is a characteristic feature especially for women.

Stiffness and stiffness in the movement of the joints that does not go away after the required warm-up. It is often accompanied by painful sensations due to arthritis developing in parallel.

Change in mood, intellectual ability... Women are characterized by increased anxiety, a tendency to depression, self-isolation. Gradually, with the development of Parkinson's disease, at a later stage in women, these symptoms become more pronounced. The ability to multitask is lost, the skill to build logical chains, to draw general conclusions from particular cases is lost.

Over time, without the necessary treatment, all of these symptoms intensify. They complicate life and make a person helpless. Unable to even button up the buttons on clothes without the support of loved ones. In order to postpone this moment as much as possible, treatment should be started immediately when the first symptoms of Parkinson's disease appear in women.

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

What it is?

Parkinson disease or idiopathic parkinsonism syndrome, trembling paralysis - slowly progressive chronic neurological disease.

It occurs as a result of progressive damage to the nervous system (NS), characterized by bradykinesia (slowing down of voluntary movements), muscle rigidity (increased muscle tone, manifested by resistance when trying to make a movement) and tremor at rest

James Parkinson described the condition in 1817 while observing Londoners walking down the street. He was able to determine that parkinsonism, as shaking palsy would later be called, refers to diseases of the central nervous system.

Etiology (causes) of the disease

There is no definitive opinion on the causes of Parkinson's disease. Doctors identify several factors that can cause the appearance of degenerative changes in the brain (GM):

  • age (the decrease in neurons during aging plays an important role;
  • burdened family history (genetic predisposition is a significant cause of parkinsonism);
  • toxic substances (it is believed that some toxins can cause damage to brain neurons and trigger the development of Parkinson's disease);

Other possible reasons:

  • infections of viral etiology;
  • neuroinfection;
  • atherosclerosis of the GM vessels;
  • traumatic brain injury;
  • the use of certain medications (for example, antipsychotics);
  • GM tumors, which can be provoking factors for the development of parkinsonism.

What are the symptoms of Parkinson's disease?

The symptoms of Parkinson's disease can progress over a long period of time, however, one way or another, they lead to disability and self-care skills. The first manifestations of the disease are:

  • general weakness, apathy, subjective feeling of ill health;
  • the gait is made unstable, with short and unsteady steps;
  • there is a change in the timbre of the voice and the pronunciation of sounds is disturbed; the patient is inclined not to bring the thought to the end during reasoning;
  • there is a change in handwriting, which becomes "shaky";
  • the patient is inclined to fall into, frequent mood swings occur;
  • the patient becomes mostly unemotional ("masked face");
  • painful muscle tension is observed, due to an increase in their tone (muscle rigidity);
  • unilateral tremor with subsequent transition to both sides;

With the further development of the disease, the symptoms of the disease become more pronounced:

  • severe rigidity is characterized by painful tension of muscles that are not able to work in concert, due to which the patient feels constant weakness and rapid fatigue is observed when performing physical exercises;
  • "Mask-like face" - the patient does not use the facial muscles in any way, the face becomes impenetrable with a constant expression;
  • there is a constant semi-bent position of the upper and lower extremities. This disease is characterized by the “cogwheel phenomenon” - when you try to straighten an arm or leg, the movement becomes intermittent.
  • the patient has a specific type of tremor - the fingers move, as if counting coins. Tremor is observed on the hands, feet and lower jaw even during rest, but disappears when the patient is asleep;
  • there is a decrease in the speed of movements (bradykinesia), which is why patients spend a lot of time on ordinary daily activities;
  • the patient begins to slouch - "the pose of the supplicant";
  • pain syndrome extends to the entire musculature of the body. Pain occurs due to continuous spasm of muscle fibers;
  • the patient begins to walk uncertainly, often loses balance and falls;
  • the inability to stay in one position;
  • the process of urination and defecation (constipation) is disrupted due to spasm of the bladder and intestines;
  • the patient will fall into severe depression, become fearful, insecure, fearful of public places, cognitive impairments are observed;
  • the voice changes (becomes nasal, unintelligible). The patient repeats the same words;
  • sweating is disturbed ();
  • sufferers often suffer from insomnia and nightmares.

How many stages of the disease are there in Parkinson's?

Parkinson's disease in its development has three stages, which are differentiated by the severity of clinical symptoms:

  1. The initial stage of the disease- this stage is partially compensated. There are minor disorders of the locomotor system, a socially patient can fully exist independently;
  2. Expanded stage- clinical symptoms are acutely expressed, the patient needs drug treatment;
  3. Late stage of the disease- the patient is disoriented in the social sphere, unable to perform normal household work; drug treatment has practically no effect.

There is also a newer and more practical classification according to Hen-Yar:

  • Zero stage- the manifestation of the disease has not yet occurred.
  • First stage- there is an unexpressed one-sided. The patient feels weakness, increased fatigue. Habitual activities (dressing, for example) begin to take a little longer.
  • Second stage characterized by the prevalence of the process on two sides: mild tremor, rigidity of the muscles of the trunk. The face becomes "mask-like" due to the defeat of the facial muscles. Dysphagia (impaired swallowing), speech impairment may occur. The patient may shake his head slightly.
  • Third stage- the manifestation of symptoms increases, but the patient is able to serve himself. The gait becomes mincing and shuffling. The patient is completely constrained in movements (his hands are tightly pressed to the body).
  • Fourth stage- pronounced hypokinesia and tremor lead to the fact that the patient is not able to carry out hygienic measures in relation to himself on his own, becomes completely incapable of physical activity. The patient can easily lose balance, so he often uses support.
  • Fifth stage- due to progressive symptoms, the patient is not able to move independently, only bed rest is indicated. Wheelchairs can be used. Due to severe dysphagia, the patient loses mass, exhaustion occurs.

Parkinson's disease classification

There are several types of this disease.

If the development of the disease occurred for no reason, with no prerequisites, then the neurologist will diagnose primary parkinsonism or idiopathic parkinsonism syndrome.

Secondary parkinsonism occurs against the background of taking medications that cause similar symptoms, intoxication, diseases that affect the brain (post-enzaphalytic parkinsonism), and cerebral circulation disorders.

Parkinsonism Plus- a group of independent degenerative diseases, the clinical manifestation of which resembles primary parkinsonism. This is:

  • multisystem atrophy;
  • cortico-basal degeneration;
  • progressive supranuclear palsy.

These diseases are not amenable to correction with antiparkinsonian drugs.

According to the presence or absence of any symptoms of the disease, Parkinson's disease is classified into:

  • disease with severe tremor;
  • diseases without tremor;
  • mixed form;
  • atypical form of the disease.

Diagnosis of Parkinson's Disease

In order to diagnose a patient with Parkinson's disease, a neurologist must collect a thorough history, conduct an examination and evaluate the results of laboratory and instrumental research methods.

During the survey, a specialist should find out the answers to such questions:

  • In which region does this patient live?
  • Did any of your relatives suffer from tremors?
  • When did the patient first notice their symptoms?
  • Have any traumatic brain injuries or diseases affecting the brain tissue?
  • What disorders of the locomotor system does the patient notice?
  • Is sweating impaired?
  • Does the patient have insomnia, how often does the mood change?
  • Did you take any medications? If so, which ones and in what dose?
  • Has the patient's handwriting changed since the first symptom appeared?

Examining a patient, a neurologist should pay attention to the patient's gait, his motor activity, tremors, emotions.

Laboratory tests will not give us a specific picture of the disease. This method is used to exclude diseases similar in symptoms to Parkinson's. The level is determined:

  • glucose ;
  • and urea;
  • cholesterol;
  • enzymes (enzymes) of the liver;
  • thyroid hormones.

Instrumental methods for diagnosing tremor paralysis:

  • Electroencephalography, by which the electrical activity of the brain is determined. With Parkinson's, this indicator decreases in relation to the norm.
  • Electromyography shows the rhythm of the tremor.
  • Positron Emission Tomography involves the use of a radioactive drug in order to determine its degree of accumulation in the substantia nigra and striatum. This indicator decreases with Parkinson's.
  • Single Photon Emission CT(SPECT or SPECT), which measures dopamine levels.
  • MRI is not a diagnostically important study in Parkinson's disease, however, in the later stages, it can reveal atrophy of the structures of the extrapyramidal system. At the same time, for differential diagnosis of Parkinson's with brain tumors and hydrocephalus, MRI has an advantage over other instrumental research methods.

There are also additional tests available to diagnose Parkinson's disease. They are not specific, however, in combination with the rest of the data, I can help a neurologist with the formulation of a diagnosis. For example, a patient needs to stretch out his arms and quickly clench his fingers into a fist several times, and then unclench. In the presence of a disease, these movements will not be performed symmetrically.

Parkinson's disease treatment

With Parkinson's, drug treatment is used to eliminate the cause of the disease - an attempt to stop the death of dopamine receptors, as well as to reduce symptoms that interfere with normal life.

Antiparkinsonian drugs

Antiparkinsonian drugs are:

  • Levodopa.

This drug is a precursor to dopamine. Converting into dopamine directly in the central nervous system, Levodopa compensates for the reduced level of this substance and removes the symptoms of Parkinson's disease: tremor, rigidity, hypokinesia, dysphagia and salivation.

In this case, Levodopa has many side effects:

  • (diarrhea or constipation, nausea, vomiting);
  • decreased appetite;
  • the formation of erosions on the mucous surface of the stomach;
  • gastralgia (stomach pain);
  • bleeding, if there is a history of the patient;
  • dizziness, insomnia or increased drowsiness, unreasonable feeling of anxiety (), depression, ataxia;
  • convulsions;
  • orthostatic collapse, decreased blood pressure;
  • interruptions in the activity of the heart;
  • accelerated heartbeat;
  • a decrease in the level of leukocytes and platelets in the blood;
  • an increase in the volume of urine excreted per day.

To reduce the side effects of Levodopa, use Carbidopa.

The next group of drugs that are used to treat Parkinson's disease are dopamine receptor agonists (stimulants). This is:

  • derivatives of ergot alkaloids ( Bromocriptine and Pergolide);
  • Pramipexole, Ropinirole.

Other less used antiparkinsonian medicines:

  • selective MAO inhibitors ( Selegiline);
  • catechol-ortho-methyltransferase inhibitors ( Tolcapon and Entacapon);
  • stimulants of dopaminergic transmission in the central nervous system ( Amantadine, Memantine, Piribedil).

Surgery

There are also methods of surgical treatment for Parkinson's disease. Exist stereotactic surgery, which implies destructive operations - thalamotomy (destruction of individual sections of the thalamus) and pallidotomy (destruction of one of the parts of the globus pallidus); applied electrical stimulation of the deep parts of the brain- high-frequency irritation of the subthalamic nucleus (the operation is complex and has many contraindications, however, with the correct procedure, patients will be able to return to their normal lifestyle); gene therapy using stem cells is currently under development.

Physiotherapy and massage

In the initial stages of the disease, these are:

  • walking;
  • swinging the upper limbs;
  • walking;
  • golf, badminton;

With the progression of symptoms of Parkinson's disease, it is recommended:

  • breathing exercises;
  • squats;
  • walking;
  • posture exercises;
  • stretching exercises.

As a therapy for Parkinson's disease, massage:

  • stroking - performed primarily to relax the muscles and prepare for further manipulations;
  • rubbing - using this method, it improves blood circulation and lymph flow, relieves tension and stiffness of the muscles;
  • kneading;
  • movement - it can be active, passive movements, with resistance;
  • blows and beating;
  • patting;
  • vibration.

Massage is an important part of the treatment of parkinsonism, because it helps to restore the functioning of the locomotor system, and also has a positive effect on the central nervous system. The recommended frequency of massage is every day or every other day.

Nutrition and diet for Parkinsonism

Patients with Parkinson's should remember that it is necessary to eat after two hours from taking medications, so that the drugs can penetrate the small intestine without obstacles and from there be absorbed into the blood in the highest possible concentration in order to exert their effect.

Nutrition should be correct and balanced with the obligatory intake of the proper amount of protein.

With this disease, patients often suffer from constipation, which is a negative effect of taking medications. Therefore, it is necessary to increase the amount of consumed fruits and vegetables.

Also, the patient should remember about normal fluid intake. You need to drink 6-8 glasses of water a day.

Dysphagia is a major problem in Parkinson's disease with meals. To facilitate this process, you need:

  • chew food thoroughly;
  • do not put the next portion of food if the previous one was not chewed and swallowed enough;
  • when swallowing, it is recommended to tilt the body forward;
  • you need to sit upright;
  • portions should be small, but meals should be in the amount of five to six;
  • it is recommended to drink water during meals;
  • food must be liquid or creamy;
  • you can not eat dry foods (crackers, cookies);
  • vegetables must be thoroughly boiled, fruits must be peeled;

Traditional medicine in the treatment of Parkinson's disease

Treating Parkinson's syndrome at home with folk remedies has a minimal number of side effects, which is undoubtedly a plus.

Recipe # 1.

300 grams of dried sage should be placed in a gauze bag and placed in a bucket. Next, you need to pour boiling water over the edge of the bucket and let it brew overnight.

Such bathrooms should be taken every other day 5 times.

Recipe # 2.

Would need:

  • 4 rose hips;
  • Bay leaf;
  • dill and parsley;
  • green apple peel,
  • 1 tsp black tea.

All components must be finely chopped, mixed and filled with 1 liter of boiling water. Let it brew for two hours. Drinking the resulting medicine is worth instead of tea every day. This recipe has no restrictions on its use, so this tea can be consumed until the symptoms of Parkinson's disease disappear.

Recipe # 3.

Chrysanthemum flowers can be brewed like herbal tea and drunk without restriction. After two months of regular use of the tea, hand tremors disappear.

Recipe # 4.

At 1 st. l. knotweed (bird knotweed), two glasses of boiling water are poured, after which the tea is infused for several hours. It should be taken half a glass at a time 5 times a day.

Recipe # 5.

Brew linden leaves like regular tea and drink in the morning. After a month of use, take a break for the same duration. The total duration of the course is 6 months.

What is the prognosis for Parkinson's disease?

Unfortunately, this disease is a degenerative disease that is prone to progression. Medicine has not yet reached such a level of development to restore the destroyed structures of the brain. Therefore, the prognosis is unfavorable.

The symptoms of Parkinson's disease can progress in each patient at a different rate, both within 20 and 5 years.

However, a timely visit to a doctor, strict adherence to his prescriptions and the fulfillment of all appointments can reduce the negative symptoms in Parkinson's disease, as well as extend the duration of work and life.

Disease prevention

In order to avoid parkinsonism, it is necessary to know the causes of degenerative processes and factors that increase the risk of the disease, as well as points that will help to avoid a terrible diagnosis:

  • Try not to work in enterprises whose activities are related to toxic substances;
  • It is necessary to maintain your immunity: a contrast shower, hardening, vaccinations;
  • If the body suffers from vascular or endocrine pathologies, then adherence to the prescribed treatment will prevent parkinsonism;
  • In case of traumatic work, it is necessary to observe safety measures; if possible, limit traumatic sports in life;
  • Monitor the daily intake of vitamins B, C, E, folic acid;
  • Healthy balanced diet;
  • Regular physical activity (walking in the fresh air, brisk and slow walking);
  • It is necessary to know and apply in practice methods of preventing stress (meditation, relaxation, micro-pauses at work, breathing exercises, planning your day, communicating with loved ones, good sleep);
  • Passing a genetic examination if there are cases of Parkinson's disease among relatives;
  • Women should carefully monitor hormonal levels (control of estrogen levels).

For any manifestation of symptoms of Parkinson's disease, you should immediately contact a neurologist to start therapy as early as possible.

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Content

Chronic disease, which mainly affects the elderly, begins to progress over time. Signs of Parkinson's disease are difficult to notice early on. Paying more attention to loved ones who have crossed the retirement age line, you can extend the period when they will be healthy.

How Parkinson's Disease Begins

Early symptoms of Parkinson's disease may appear long before old age. If there are concerns that you or your family members have a predisposition to the disease, you need to be examined at a medical center. It is worth noting that when a young man aged 37-45 sleeps restlessly, often changes his posture, during rest there is an involuntary twitching of the muscles, inhibition of thinking of a previously erudite person. This indicates the first signs of an emerging disease, the diagnosis of which should be identified as early as possible.

Parkinson's stages

Medical institutions use the classification of stages of parkinsonism, which was derived about half a century ago. Having undergone some adjustments and refinements, the course of Parkinson's disease looks like this:

  • First stage. The early signs of the disease appear asymmetrically relative to the body, on the one hand, they are insignificant. The patient does not attach importance to some "disobedience" of the limbs.
  • Second stage. The disease spreads to both halves of the body and limbs. Outwardly, this is imperceptible, the patient himself copes with the work and can serve himself on his own.
  • Third stage. Difficulties arise from time to time when doing any work. The patient begins to complain about the limitation of his actions. The general mode of life remains the same.
  • Stage four. Pain and loss of coordination are worse. Movement is possible only with assistance.
  • Fifth stage. The patient is confined to bed, due to complete disability, independent motor activity is impossible.

The first signs of Parkinson's disease at the prodromal stage of the disease

Being attentive to people of advanced age, you can notice signs of an approaching disease that develops rapidly, progresses, leads to the loss of the ability to move and complete disability. Discount for age, untimely medical support can cost a short-term deterioration in health. By carefully listening to the complaints of elderly people, you can extend the period of their full life.

Partial loss of smell

In 7-9 out of 10 cases, patients have an early loss of smell or partial loss of smell. The early stage of Parkinson's disease is characterized by a disruption in the work of certain parts of the brain that affect the olfactory bulbs. This symptom can be traced several years before the onset of tremor of the arms and legs and is a harbinger that should be paid close attention to.

Symptoms of the disease at an early stage are considered to be slight tremors of the hands or individual fingers, twitching of the muscles of the foot of one or both legs. A feature is the characteristic involuntary movements of two or three fingers, which outwardly look like rolling an object. The more the patient is excited or is in a state of fear, stress, the more noticeable the tremor. Having calmed down, the person does not feel discomfort, the trembling of the limbs disappears. There is no tremor during sleep.

Memory impairment and speech impairment

Symptoms of the disease can manifest itself as quiet indistinct speech, loss of intonation, monotony. When repeating what has been said, the patient begins to get nervous, stumble, phrases become incoherent and even quieter. The death of brain cells actively affects the deterioration, and subsequently the loss of memory and dementia. An elderly person ceases to recognize even the closest relatives, forgets episodes of his own life. During speech, individual words are lost, a loss of the train of thought is noted.

Slight muscle stiffness

Stiff muscle mobility has become one of the main symptoms of Parkinson's disease. The work of any muscle in the human body is based on its tension during contraction, while the opposite must be completely relaxed. When there is a malfunction and imbalance in the balance "work - rest" of the muscles, then the movements begin to become difficult, outwardly look intermittent, the patient quickly gets tired. Disproportionate muscle activity brings a feeling of weakness, rapid fatigability.

How does the disease manifest at an early stage when moving

It is easy to identify a person suffering from severe Parkinson's disease by movement. The gait becomes shuffling, slow, careful, small steps. Often, with an illness, a person begins to hunch down, the shoulders look drooping, the head tilts forward. Imbalance can lead to the patient falling down, he will not be able to stand up on his own.

During the movement, sometimes there comes a moment of numbness. The patient stops, freezes in place, is unable to take a single step, much less run. The position of the body becomes unstable, unsteadiness appears, he can easily fall. It is difficult to make tilt movements, to pick up any object from the floor. In a supine position, without assistance, he cannot turn on his side or sit down, stand up.

Characteristic early symptoms at rest

The patient can be calculated by some of the symptoms that appear at an early stage of the development of the disease, even if he is at the moment without active movement. An experienced doctor will look for minor signs that indicate that Parkinson's disease has begun to take effect in the body. Here are the symptoms of pathology, the manifestation of which indicates the initial stage of the disease:

  • Change the tone of voice. A nasal, monotony of reproducing sounds appears. Speech becomes quieter and more unintelligible as the disease progresses.
  • The handwriting changes, becomes small, illegible, with "trembling" letters.
  • Sleep is disturbed. Nightmares are frequent at night. Sleep is difficult, sometimes restless. In the daytime, there is increased drowsiness.
  • Unreasonable depression, mood swings are characteristic symptoms in the early stages of Parkinson's disease, which can be corrected with medication.
  • Pronounced emotions of fear, uncertainty, fearfulness often become constant companions of a person who suffers from a disease.
  • Muscle malfunctions, spasms are observed not only in the smooth muscles of the body, but also in the facial ones. Difficulty chewing and swallowing create certain problems in the patient's everyday life. Outwardly, the face often resembles a frozen mask with motionless facial expressions, the absence of any expression.
  • Malfunctions of the nervous system affect the condition of the skin. It can be excessively oily, especially on the face and scalp, or, on the contrary, very dry. The symptom is treatable.
  • The genitourinary system and the gastrointestinal tract are often affected. Frequent constipation, urinary incontinence make the patient feel discomfort, constant insecurity, create many everyday problems.
  • The syndrome of slowing down even reflex movements (hypokinesia) makes it difficult to independently perform elementary life activities - eating, washing, dressing.

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About existence Parkinson's disease (PD) mankind has known for about 2 hundred years. And although the features, the therapeutic effect and the mechanisms of its course have been studied in sufficient detail, the "white spots" - regarding the prevention of a serious illness, the clear reasons for its inception - are not diminishing.

What it is

The disease "inherited" its name from the name of the doctor who first described it in detail - the Englishman James Parkinson, who described the disorder as "shaking" paralysis. This neurological pathology is multifactorial (affects various body systems) and extensive damage to the central nervous system.

PD progresses slowly and steadily, interferes with the work of the human brain, leading to the death of dopaminergic neurons in the substantia nigra (located in the midbrain), which is responsible for the regulation of the body's motor function, muscle tone, and is involved in the implementation of many autonomic functions.

In addition, the disease initiates a number of disorders non-motorized character:

  • sensory (pain, burning, numbness, tingling, impaired sense of smell);
  • mental (apathy, depression);
  • vegetative (tone of blood vessels, respiration, heart activity).

PD is characterized by age-related features. As a rule, the first signs of the disease may have individual manifestations already at 50-55 years old... In the age subgroup up to 65 years old the prevalence of the disease rises to 1%; at 65-75 years old- already up to 2%; and the incidence of the disease from 3 to 4% is noted at the age 75+ .

The WHO records the digital indicator of patients with PD in the amount of 3.7 million, each year there is an "increase" in the number of cases by 300 thousand people. The incidence of Parkinson's disease per 100 thousand population, according to various studies, averages 60 to 180 cases.

ICD-10

Parkinson's disease has a separate ICD10 code. In this classifier, the disease is assigned to the class G20 (primary parkinsonism) consisting of:

  • hemiparkinsonism- unilateral parkinsonian syndrome (a consequence of trauma, brain damage);
  • trembling paralysis- chronic and progressive tremor (tremors) against the background of damage to the cortical nodes of the brain;
  • Parkinson's disease- a general disease, accompanied by degenerative processes of certain parts of the brain, which is accompanied by slowness in movements, muscle rigidity, tremor at rest, impaired reflexes when taking a pose.

There is also secondary parkinsonism (class G21) - the cause is environmental factors (drugs, inflammatory processes of the brain, its toxicity, tumors, strokes) and diseases with PD symptoms, but representing disorders of the nervous system of a degenerative type against the background of another disease (class G22 , 23).

Should be divided parkinsonism and Parkinson's disease- their difference is that the first term characterizes a complex series of irreversible changes in the activity of the human nervous system in general. PD is a separate disease with its own symptoms, which should be addressed during treatment.

Symptoms and Signs

Specialists combine the characteristic parkinsonian symptoms into a triad:

  1. Violation of initial motor functions and a slowed down tempo of movements - akinesia ... There is also a decrease in the amplitude and speed of repetitive actions, although muscle strength is not lost. Akinesia is manifested:
  • in facial expressions (immobility of the face),
  • in speech disorders (monotony, mumbling, slowness),
  • in respiratory disorders (intermittency, increased frequency),
  • in the deterioration of elementary actions (turning in bed, shuffling with short steps and stooped gait).
  1. A feeling of constriction (throughout the body, muscles) and general stiffness - rigidity ... For PD, a certain kind of muscle tone is characteristic - viscous, monotonous, its intensification is observed during the repetition of passive movement. Asymmetry of muscle tone (increased in the limbs) is typical.
  2. Trembling limbs at rest - tremor ... A decrease in tremor is observed in the case of stretching the arm, with an increase in motor activity.

Symptoms and signs: photo

Non-motor manifestations are also characteristic of PD:

  • mental and neuropsychic nature (panic attacks and increased anxiety, depression, lethargy and indifference, obsessive states, in rare cases - psychosis);
  • deterioration of autonomic functions (experience of choking, dry mouth, impaired excretory functions - difficulty urinating and constipation, excessive sweating);
  • deterioration in the quality of sleep and its mode (sleepiness during the day, inability to fall asleep at night, excessive brightness of dreams);
  • disturbances of the sensory system (increased / decreased sense of smell, pain in the limbs or throughout the body, the experience of paresthesia - numbness, burning, crawling creeps, tingling).

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Causes of occurrence

Researchers and medical specialists are not yet unambiguous about the causes of PD. The most common factors that determine the disease include:

  • family predisposition - genetic factors that contribute to the development of PD (although the gene responsible for the onset of symptoms has not yet been identified);
  • external influence - the influence of toxins (including various medications), the transfer of acute and chronic infections of the nervous system, tumors and trauma of the nervous system / brain.
  • the aging process of the body - acceleration of the death of nerve cells responsible for the implementation of motor functions, deterioration of blood circulation in the brain.

Young

Symptoms and signs in young or adolescent PD patients are in most cases similar to the classic variant of the disease.

  • Early (juvenile) parkinsonism tends to manifest itself in the age period 20-40 years old ... In the course of the disease, secondary signs that are not associated with motor activity begin to appear - the disease does not affect the substantia nigra (as in elderly patients), but other parts of the brain.
  • Motor manifestations are reduced to an involuntary and painful contraction of the muscles of the shoulder girdle and feet, as well as involuntary motor activity in the limbs or the body in general.

In general, the disease is mild at a young age, because there is no presence of many disorders of the physiology of the body inherent in older patients.

Treatment

Traditional approaches to the treatment of PD are reduced to the implementation of such methods:

  • maximum deceleration or complete stop of the death of brain neurons ( neuroprotective therapy) - through taking medications that stimulate the reduction of degenerative processes;

  • reduction of the detrimental effect of the main symptoms of PD ( symptomatic therapy) - timely response to their most acute manifestations through the correction of the imbalance of neurochemical and neurophysiological processes in the brain;
  • restoration of physical and socio-psychological functions - by physiotherapy exercises and psychotherapeutic influence.

During treatment, special attention should be paid dosages drugs - a positive effect should be provided with minimal, but effective doses, contributing to the recovery of motor functions affected by the disease.

Life span

When characterizing Parkinson's disease, how long patients live with it, and how long it can last, several points should be noted:

  • the patient's life expectancy depends on the specific form of PD and the stage of its development, but the general data are as follows: patients who develop PD after 65 years live from 5 to 7 years; 20-21 years - life span at the age of onset of the disease in 40-64 years; 37–39 years old, if the disease began at the age of 20–39 years;
  • although in most cases PD patients can live a significant period of time in the fight against the disease, adaptation to it is significantly more difficult, while the quality of life is significantly reduced;
  • the most difficult factors are experienced by patients: loss of dexterity of the upper limbs; the inability to adequately show your feelings, overcoming apathy and external indifference; significant loss of performance and motivation to be active in general.

The specificity of BP is such that it is not tied either to the sphere of habitation (it manifests itself on all continents, in all countries), or to material status or social status - both “average” people and people with wealth and fame are exposed to it.

One of the picturesque examples is Vyacheslav Zaitsev, who announced his own fight against the disease on one of the central TV channels. The famous couturier had to undergo a number of medical procedures, including both drug and movement therapy. A positive attitude and maintaining motivation for vigorous activity made it possible to coexist relatively well with parkinsonism.

Despite the status of an incurable disease, one can successfully live with PD if efforts are made to adapt the patient to new living conditions as efficiently as possible, the necessary healing therapeutic procedures are implemented and there is support from the closest social environment.

Parkinson's disease refers to neurological diseases, when, against the background of degeneration of the extrapyramidal system, the destruction of brain cells occurs. An exciting issue is the initial stage of Parkinson's, the symptoms of which are important not to miss. Pathogenetic therapy has been developed using conservative and surgical techniques that can improve the quality of human life and stop the development of pathology.

Causal factors of the onset of Parkinson's

The symptoms of Parkinson's onset are associated with several factors: aging, genetic determinism, and environmental influences. The beginning is accompanied by changes in the substantia nigra and the appearance of Levi's bodies. The level of dopamine, which is considered the hormone of pleasure and joy, decreases. In addition, the number of dopamine receptors that are sensitive to the hormone of the same name is reduced.

Main hypotheses for the onset of Parkinson's disease
Etiology Description
Genetic conditioning According to statistics, about 14-15% of patients with Parkinson's have a burdened hereditary history. Scientists have not identified the genes responsible for the onset and development of idiopathic parkinsonism.
Environmental reason The impact of pesticides and herbicides on the human body has been proven in laboratory conditions. Found inhibition of the respiratory chain complex in cell organelles - mitochondria. Risk factors and early stage of Parkinson's disease may be associated with long-term residence in rural areas and in the vicinity of industrial enterprises.
Oxidative hypothesis Assumptions have been put forward regarding free radicals that can enter into a biochemical reaction with unsaturated fatty acids of cell membranes, thereby destroying their structure.
Cerebrovascular insufficiency Chronic impairment of blood circulation in the brain leads to an insufficient supply of nutrients to neurocytes. Depletion of microcirculation slows down metabolic processes and contributes to the extinction of the work of the parts of the brain.

As a rule, the initial signs of Parkinson's disease occur against the background of a combination of several etiological factors. In the case of a genetic predisposition, additional factors can contribute to the early manifestation of neurological degenerative pathology.

Important! According to statistics, people who regularly take caffeine have a lower risk of developing Parkinson's disease - the substance has a dopamine-stimulating effect.

Cardinal initial symptoms

Parkinson's disease manifests itself at the initial stage with motor, autonomic and mental changes. Patients do not notice how appetite decreases and body weight decreases. The onset is accompanied by metabolic disruptions and changes in food cravings. The work of the sebaceous and sweat glands increases, the face acquires shine regardless of the intensity of physical activity.

  • signs of the onset of psychosis: anxiety, fear, absent-mindedness;
  • hallucinatory and paranoid states;
  • depression;
  • insomnia;
  • rapid fatigue and lack of initiative.

Parkinson's motor early signs include several conditions: tremor, hypokinesia, muscle rigidity, and postural instability. Violations of the sphere of motion tend to grow and intensify.

Trembling or tremors

The onset of Parkinson's disease is accompanied by trembling of the limbs, and then of its individual parts. The syndrome is one of the most obvious and quickly noticeable surrounding signs. It is noteworthy that the onset is due to the occurrence of a tremor of the fingers on one hand, then gradually passes to the opposite side and legs. It intensifies at rest, and disappears with dynamic movement.

Multidirectional movements of the upper limb fingers can resemble coin counting or capsule rolling, similar to the pill-forming technique used in the pharmaceutical industry. Parkinson's onset may be characterized by head tremors in the vertical or horizontal axis, of the yes-yes or no-no type, respectively.

Important! In differential diagnosis with cerebellar tremor, when tremor always follows the patient, tremor in Parkinson's is characteristic only in a calm state and disappears when movements are performed.

Hypokinesia

The definition of hypokinesia means a decrease in active movements. When Parkinson's disease develops, the initial symptoms in the form of hypokinesia or bradykinesia are intimidating. Relatives notice that a sick person freezes and stays in one position for a long time. The onset of pathology is characterized by the stiffness of the whole body. The movements are performed as if "reluctantly" with some delay.

Signs of the onset of Parkinson's disease: walking with a shallow gait, feet parallel to each other, lack of facial expressions, feeling of a frozen gaze, rare blinking of the upper eyelid. The facial muscles tighten with a slowdown, the reaction to news and conversation is slowed down. The beginning is accompanied by the appearance of a frozen grimace of joy, happiness, grief or crying.

The speech function is disturbed, deprived of expressiveness and emotionality. The handwriting and the peculiarity of writing words on paper are changing - small letters with jagged movements in places where smooth lines are assumed.

Muscle stiffness

Muscles lose their plasticity, after giving a certain position, the limbs are difficult to flex and extend. The beginning is accompanied by stoop, head tilt forward, legs and arms bent at large joints. The upper limbs are along the body, there are no sweeping movements. A cogwheel symptom appears when, if you want to straighten the patient's arm, an intermittent muscle contraction is felt.

The beginning of the development of pathology is combined with the Westfall phenomenon, when, with a passive effect on the foot of a patient with Parkinson's with dorsiflexion and tension of the muscles of the foot, the foot retains its position for some time. The onset is characterized by the appearance of a waxy plasticity of the skeletal muscles.

Postural instability

The initial stage of Parkinson's is rarely accompanied by postural instability, the symptom is more characteristic of the late stage, when it is difficult to overcome the inertia of active movement or the inertia of absolute rest. The body is, as it were, ahead of the movement of the legs. The center of gravity and stability are lost. Falls with trauma to soft tissues and bones are inevitable.

The onset of the disease is determined by the appearance of paradoxical kinesias. Due to emotional stress, worries, stress or tension, instability, muscle rigidity, hypokinesia and tremor are eliminated. The person moves easily for 1-3 hours, after which the pathognomonic symptoms return.

Additional signs

Indirect symptoms of the onset of Parkinson's disease indicate the onset of the disease and its further progression. Each of the signs individually can be present in other diseases, but the combination of several suggests a neurological degenerative pathology.

Additional signs:

  1. Changes in olfactory perception - the clear sense of smell of products with a pronounced aroma is lost. The exceptions are colds and chronic respiratory diseases.
  2. Violation of taste buds - the usual and favorite food does not bring pleasure, the taste is perverted. It is caused by a violation of the synthesis and metabolism of dopamine.
  3. Change in handwriting without the appearance of micrography - if a change in the amplitude of the written letters and numbers is noticed, the smoothness of the lines is worth contacting a neurologist.
  4. Restlessness during night sleep - twitching of the limbs, flinching and other sudden movements may indicate the onset of Parkinson's.
  5. Fading of the voice - the timbre becomes quieter, the person speaks almost in a whisper. Onset with speech disorder - trembling voice and lack of intonation.
  6. Slowness of movements - not only gait becomes slow, but also speech, reading speed.
  7. Constipation and a feeling of incomplete emptying of the intestines - such symptoms of Parkinson's disease at the initial stage may not be perceived as leading due to medication intake, dietary changes, diseases of the gastrointestinal tract, or decreased motor activity.
  8. The impression of a mask on the face is created - the person loses the speed of reaction to the information heard, seen or read. Mournful or crying facial expressions, even if the mood is good.

Excessive sweating and soreness in the cervical spine are considered additional initial symptoms of Parkinson's. Hyperhidrosis is caused by the involvement of the autonomic nervous system, and therefore, against the background of complete well-being and the absence of heat, a patient with Parkinson's may sweat. Neck pain appears with an uncomfortable posture during rest and compression of the vertebral artery.

Treatment methods

Pathogenetic treatment at the initial stage of Parkinson's disease is divided into conservative and surgical. Conservative therapy includes medications that can eliminate hypokinesia, rigidity, tremor, and dysphagia. The beginning is accompanied by drugs of choice: Levodopa, Bromocriptine, Amantadine, Selegiline.

Surgical destructive therapy is represented by thalamotomy (destruction of the ventral nucleus of the thalamus) and pallidotomy (partial destruction of the globus pallidus). Prescribed in case of ineffectiveness of conservative treatment of the onset of the disease.

The onset of the disease can be halted with neurosurgical stimulant therapy. An innovative stereotaxic frame is used with head fixation and installation of the subcutaneous parts of the system - connectors and a pulse generator.

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