Everything you wanted to know about Parkinsonism...

Parkinson's disease, or "trembling paralysis"
Viktor Amosov, neurologist
Magazine "60 years is not an age"

Many people are interested in this disease, if only because it struck such famous people as boxer Mohamed Ali, Pope John Paul II, Hollywood actor Michael J. Fox, who played the main role in the film "Back to the Future". But, of course, Parkinson's disease affects hundreds of thousands of ordinary people who want to alleviate its symptoms.

The "black substance" suffers "Trembling paralysis" was first described by the physician James Parkinson in 1817.

This chronic progressive disease of the central nervous system began to be called by his name.

Most often, Parkinson's disease develops at the age of 50-65 years, although in 10% of people it manifests itself before the age of 40. Moreover, both men and women get sick with the same frequency. Social and living conditions and place of residence do not matter either. Scientists suggest that with an increase in the average age of the population in the coming years, the prevalence of the disease will increase.

Since the concept of "parkinsonism" is applied to any syndrome (complex of symptoms) in which neurological disorders characteristic of this ailment are observed, primary and secondary parkinsonism should be distinguished.

The primary one is Parkinson's disease itself, caused by hereditary factors and accounting for 80% of all manifestations of the disease. Secondary, or Parkinson's syndrome, does not manifest itself by itself, but against the background of other diseases and disorders in the body.

Thanks to many years of research, it turned out that Parkinson's disease affects a certain part of the brain, which is called the "black substance". This part of the brain produces an important chemical called dopamine. The function of dopamine is to transmit signals to the part of the brain that controls movement. As a result, the muscles contract without any difficulty, and the person performs all the movements that he wants to perform.

In Parkinson's disease, the nerve cells that produce dopamine die off, and dopamine production decreases. As a result, the normal transmission of nerve impulses is disrupted, and the main symptoms of Parkinson's disease arise – disturbances in human movements.
The sequence of the appearance of individual symptoms of Parkinson's disease varies from person to person. For some, it all starts with trembling, for others – with stiffness and slowness of movements.

The reasons are not completely clear, but... To date, the exact cause of the death of nerve cells responsible for the production of dopamine has not been established.

Nevertheless, the factors contributing to the development of the disease are known.

Aging of the brain. One of the main factors is an age-related decrease in the number of dopamine-producing neurons. Every 10 years of life, about 8% of these cells are lost. However, the brain has the ability to compensate for such losses, and a person lives fully, often maintaining a good memory, excellent mental abilities and a favorable state of health until old age. But if the loss of neurons reaches 80% of their total mass, then the brain is no longer able to compensate for their absence. That's when the symptoms of Parkinson's disease appear.

Heredity. According to scientists, the genetic factor also plays an important role in the development of pathology. If a close relative of a person suffers from Parkinson's disease, then the risk of getting it for this person is doubled compared to other healthy people. Apparently, hereditary mechanisms contribute to the faster death of neurons and the formation of increased human sensitivity to external factors that can provoke the development of the disease (poor ecology, infections, exposure to heavy metals and other toxic substances).

Toxins and other harmful substances. In 1977, a number of cases of severe Parkinson's disease and manifestations of signs of Parkinsonism in young drug addicts who took synthetic heroin were described. This fact suggests that various chemicals can "trigger" a destructive process in brain cells and cause manifestations of Parkinsonism. Observations, for example, show that people working with herbicides and pesticides have a much higher risk of developing Parkinson's disease. However, scientists have not yet been able to establish an exact connection between this or that toxic substance and this ailment.

Medicines. Taking certain medications for a long time or in large doses can cause symptoms of parkinsonism. These include, in particular, haloperidol and chlorpromazine, which are prescribed for the treatment of a number of mental disorders, the anti-nausea drug metoclopramide, the anti-epilepsy drug valproate. In most cases, the symptoms of the disease disappear after stopping taking medications. However, all cases of the disease are individual, so you should not risk your health and use any medications uncontrollably, without a doctor's appointment.

There are also various diseases and conditions against which secondary parkinsonism may occur. These are viral infections, atherosclerosis of the cerebral vessels, severe and repeated traumatic brain injuries, encephalitis, brain tumors, drug addiction, and some hereditary diseases.

Symptoms of the disease If you notice that your handwriting has changed – the letters have become softer and more clumsy, or the fingers on your hand have begun to tremble, then do not be lazy to go to a neurologist.

These may be symptoms of Parkinson's disease. Its first symptom may also be stiffness of the muscles, including facial muscles. In this case, the face becomes like a mask.

But most often Parkinson's disease is accompanied by tremor, or trembling of the arms and legs (at first it can occur only in one arm or leg). Basically, the tremor manifests itself when a person wakes up, sits or stands, so this phenomenon is called "rest tremor". The tremor decreases when moving the leg or arm. Tremor can also manifest in the chin, lips and tongue.

At the beginning of the disease, tremor often occurs only on one side of the body, and with the progression of the disease it can spread to its other side (although in some cases the tremor remains in the same localization).

In order for the tremor to bother a person as little as possible, he needs to be protected from strong emotions. Any stress leads to the fact that the shaking becomes more noticeable. To reduce the degree of its manifestation, and sometimes completely stop it, full sleep and complete relaxation help.

Although trembling of the limbs is the most common sign of Parkinson's disease, not every person with this diagnosis suffers from tremor. At the same time, trembling of different parts of the body can be observed in other diseases. In such cases, unlike the tremor caused by Parkinson's disease, the tremor decreases when the arm or leg is at rest, and increases with movement. So, noticing a characteristic tremor, you need to establish its exact cause with the help of a doctor.

Rigidity (stiffness) of muscles is another early sign of Parkinson's disease. Because of it, there is a decrease in the amplitude of the swing movements of the hand on one side of the body while walking. Rigidity also occurs in the muscles of the legs, face, neck and other parts of the body. The muscles are always in high tone, which causes the characteristic slouching posture of a person with Parkinson's disease. It even got its name — the "supplicant" pose.

Rigidity causes a sick person to feel tired and sore in the muscles. It is often with complaints of pain that people turn to a doctor. At the same time, it is very important to undergo a thorough examination, because such painful sensations in the muscles are similar to signs of rheumatism.

Hypokinesia, or bradykinesia, is manifested by slowing down or reducing the number of movements. Those around the patient note a noticeable impoverishment of his facial expressions and gestures. And the patient himself describes this condition as a feeling of weakness and fatigue. The greatest difficulty for him is the beginning of movement, as well as the coordinated, precise execution of the entire motor act. For example, it may be difficult for a person to get out of a chair or turn over from side to side in bed, get out of bed after waking up without assistance. Hypokinesia is most often manifested in the trunk, limbs, in the muscles of the face and eyes.

Postural instability is another sign of Parkinson's disease, meaning difficulties in maintaining balance when walking, that is, gait disorder. A person suffering from Parkinson's disease for a long time walks with small steps and at the same time shuffles his feet, rearranging them close to each other. The body leans forward, there is a stooped posture. In addition, it is difficult for a person to turn around, because of an imbalance, he may fall. Relatives should remember this and insure the patient to prevent a fall.

There are still a number of symptoms that can seriously reduce the quality of life of the patient. Due to the weakness of the muscles of the face and throat, difficulties may arise when talking, swallowing, a feeling of suffocation, coughing, drooling may appear. The patient's speech becomes more monotonous, the ability to move the muscles of the face is lost, which can lead to a change in facial expressions. A person has a persistent, indifferent expression on his face, as if he does not feel emotions or is constantly angry. It is not by chance that such a thing as a "Parkinson's mask" appeared. Needless to say, the sign is not the most pleasant, but, fortunately, it can be successfully combated by performing special exercises for the facial muscles. I will tell you about them later when we talk about therapeutic gymnastics.

The change in handwriting, which I mentioned above, is due to a deterioration in the flexibility of small joints of the hands and a violation of coordination, which, for example, makes it increasingly difficult for a person to dress and eat. In order for this symptom not to progress and manifest itself as late as possible, it is necessary to constantly engage in therapeutic gymnastics.

Not the main, but a common sign of Parkinson's disease is a violation of the digestive and urinary system (constipation, urination disorders, which can be frequent and sometimes involuntary). Reflex functions of the body are also disrupted, the work of the sebaceous and sweat glands changes (excessive sweating, dandruff appears, the skin becomes oily), blood pressure decreases, sexual function weakens. The causes of such manifestations may be not only Parkinson's disease, but also concomitant diseases, as well as medications used for treatment. However, with proper treatment and self-care, they can be eliminated, and cosmetic problems can be minimized.

Another characteristic symptom is "freezing" or "jamming". It is characterized by a sudden short-term inability to move, most often while walking.

Parkinson's disease is often accompanied by sleep disorders. One of the reasons for this is that it is difficult for patients to change their position during sleep.

Patients are also characterized by thinking disorders, sudden mood changes – from 30 to 90% of them suffer from depression. They may also develop fearfulness, indecision, passivity. A course of positive psychotherapy helps to get rid of negative emotions.

A small percentage of people with Parkinsonism suffer from an inability to think clearly, understand and remember. This symptom manifests itself only in the very late stages of the disease.

Portal "Eternal youth" http://vechnayamolodost.ru21.02.2011