Description

Parkinson’s Treatment

Parkinson’s disease, which was first described as shaky
paralysis in 1817 and entered the literature, is a slow-progressing movement
disorder with loss of brain cells, which is more common in men compared to
women. Although the disease seen in older ages most frequently occurs
between the ages of 40 and 70, in 5% of Parkinson’s patients, the disease can
also occur between the ages of 20 and 40. Its prevalence in the population
aged 65 and over is 1%.

What is Parkinson’s disease?

In the human brain, there are regions called substantia nigra
where dopamine producing cells are densely located. Dopamine, a kind of
chemical substance produced in these regions, provides the communication
between the brain regions called the striatum, which allows the person to
control their movements. When dopamine cells are decreased in high
amounts, dopamine production is insufficient, causing the emergence of
non-rhythmic, incoherent, shaky and non-fluid movements, which are symptoms of
Parkinson’s disease. The incidence of the disease is higher in people with
a history of Parkinson’s disease in their mother, father or sibling compared to
the general population. The disease begins at a younger age in members of
families with a genetic history. This condition accounts for 5% of
Parkinson’s patients.

Parkinson’s symptoms

Parkinson’s disease is a slowly progressing
neurodegenerative disease. Its onset is characterized by symptoms of a
motion system malfunction. It shows symptoms such as decreased mimics,
monotonization and distortion of speech, a slight forward-bent position of the
trunk, slowdown in movements, tremors, pain in the arms and limitation of
movement. The insidious course of the disease initially causes it to be
associated with the normal aging process, depression or joint
diseases. Parkinson’s patients are misdiagnosed with depression, shoulder,
neck and arm pains 4 to 6 years before the symptoms appear. The most
common initial symptom of the disease, It is the tremor in one hand and
fingers during rest and the absence of arm swing accompanying walking on the
same side. The tremors may rarely begin in the foot, jaw or
tongue. Slowness in movements without tremors may also be a starting
sign. The first symptoms include a decrease in arm swing movement
accompanying walking, decrease in skill in the affected hand, decrease in writing,
impoverishment of gestures, stiffness in one leg while walking, and standing
shuffling. Symptoms that first appear in the course of the disease usually
spread to other extremities on the same side, and as the disease progresses, it
also occurs in other extremities. The spread of the disease in cases that
started in the upper extremities, hands, arms, feet, legs, face, It
appears to follow the order of speaking and swallowing. In cases where the
symptoms start in the lower extremities, there is a sequence of foot, leg, arm,
hand, face, voice and swallowing disorder. According to the stages of
Parkinson’s disease, the symptoms are as follows:

Stage 1: Signs and symptoms are unilateral and
mild. It does not cause disability. Often there is tremors in one limb. Only
the relatives of the patient notice the disturbances in mimic, posture and gait.

Stage 2: Symptoms are seen on both sides at this
stage. There is very little disability. Posture and gait are affected.

Stage 3: Significant slowing in trunk movements, impaired
balance and falling are observed. Moderate diffuse dysfunctions are
observed.

Stage 4: Symptoms are severe at this stage. The
patient can walk, albeit with difficulty. There is slowing and stiffness
in the movements. Shivering may be less than previous stages. This
group of patients does not live alone without assistance.

5. Stage: The patient is dependent on a bed and a
wheelchair and needs constant care.

How is the diagnosis of Parkinson’s?

The diagnosis of Parkinson’s disease is made by a
neurologist by history and physical examination. There is no mandatory
brain imaging or blood test to confirm Parkinson’s disease. If the
physician deems appropriate, radiological imaging is used for differential diagnosis
of the disease and to rule out other possible causes.

Parkinson’s treatment

Parkinson, which is one of the many diseases caused by cell
loss in the brain, is the type that responds best to treatment among these
diseases. However, since the disease progresses slowly, the patient should
be under constant follow-up of the physician. Since Parkinson’s is a
disease that decreases the quality of life over time, family members should be
conscious and provide the necessary support to the patient and ensure the
correct application of the treatment. It is also very important in terms
of treatment to consult a neurologist as soon as the symptoms of the disease
appear. Early treatment slows down the progression of the disease and
improves the patient’s quality of life. Many different treatment methods
can be applied by the specialist physician according to the stages of the
disease. First of all, it is aimed that the patient can continue his own
life without addiction. The decrease in dopaminergic nerve signals that
develop with the loss of dopamine-producing cells is balanced with the drug. In
recent years, typical symptoms of the disease are improved and the quality of
life is improved with deep brain stimulation known as brain pacemakers, which
can be applied to some patients. Deep brain stimulation consisting of
stimulation electrodes roughly placed in the relevant regions of the brain and
a battery placed under the skin in the chest or abdomen, The chance of
success increases when the correct diagnosis is made by an experienced team in
selected cases. In addition, physical exercises that Parkinson’s patients
will apply in addition to drug treatments are also highly beneficial. Since
the exercises have a positive effect on muscle stiffness and slowness of movement
as well as making the person feel better, it is recommended that the patient
should exercise in line with the needs and range of motion. Especially in
the early stages of Parkinson’s patients, since their movements are not
restricted yet, they can exercise easily. These movements increase the
mobility of people, It encourages a more active life and makes it easier
to act. Exercise movements that increase dopamine transmission in the
brain also help increase cognitive functions and mobility. The movements
organized by the physiotherapist according to the stage of the disease and the
condition of the person do not cause fatigue, on the contrary, they will
provide vitality. These exercises consist of many movements such as
walking, button-up and opening, gestures, getting up and lying down, dressing,
sound, breathing, chin-lip and exercises to correct speech disorder. Exercise
movements that increase dopamine transmission in the brain also help increase
cognitive functions and mobility. The movements organized by the
physiotherapist according to the stage of the disease and the condition of the
person do not cause fatigue, on the contrary, they will provide vitality. These
exercises consist of many movements such as walking, button-up and opening,
gestures, getting up and lying down, dressing, sound, breathing, chin-lip and
exercises to correct speech disorder. Exercise movements that increase
dopamine transmission in the brain also help increase cognitive functions and
mobility. The movements organized by the physiotherapist according to the
stage of the disease and the condition of the person do not cause fatigue, on
the contrary, they will provide vitality. These exercises consist of many
movements such as walking, button-up and opening, gestures, getting up and
lying down, dressing, sound, breathing, chin-lip and exercises to correct
speech disorder. The movements organized by the physiotherapist according
to the stage of the disease and the condition of the person do not cause
fatigue, on the contrary, they will provide vitality. These exercises
consist of many movements such as walking, button-up and opening, gestures,
getting up and lying down, dressing, sound, breathing, chin-lip and exercises
to correct speech disorder. The movements organized by the physiotherapist
according to the stage of the disease and the condition of the person do not
cause fatigue, on the contrary, they will provide vitality. These
exercises consist of many movements such as walking, button-up and opening,
gestures, getting up and lying down, dressing, sound, breathing, chin-lip and
exercises to correct speech disorder.