Parkinsonism is a neurological syndrome characterized by a disorder of voluntary movements. This pathology accompanies a variety of diseases and always causes slowness of movements, trembling of limbs, stiffness of muscles.
Case history
Symptoms of the disease in neurology have been known for a long time. But they are most fully described in James Parkinson's Essay on the Jitter Paralysis.
Its publication took place in 1817.In this work, the distinctive features of this disease were shown. The doctor noted a strange condition, which was accompanied by impaired motor functions, tremor of rest, stiffness of muscles.
In addition, the scientist managed to assess the dynamics of these signs as the pathology develops. After that there was a question about the etiology of the disease.
So, Edward Brissot put forward the hypothesis that the legs and the subthalamic nucleus of the brain are responsible for the development of pathology. Frederick Levy managed to identify specific cellular inclusions, which were later called "Levi bodies".A Russian neurologist Tretyakov K.N.found that pathological disorders develop in a black substance.
Forms of
Specialists distinguish two forms of parkinsonism:
Primary .This species is Parkinson's disease, which is directly related to the death of nerve cells. In this case, the following features are characteristic:
- old age;
- presence of at least two main manifestations of pathology;
- feature asymmetry or unilateral manifestation.
Secondary .This Parkinsonism is associated with the impact of external factors. These include infections, the use of medication, trauma. For this type of pathology are characterized:
- vascular disorders;
- vegetative disorders;
- acute onset of the disease with subsequent stabilization;
- Symmetry of Characteristics;
- is a negative event before the onset of symptoms - trauma, contact with chemicals, excess dosage of antipsychotics, encephalitis.
Symptoms of parkinsonism is tremor. Read more about the causes of head tremors, ways of diagnosis and treatment.
About the manifestation of the benign tremor and its prevention is described in this article.
Etiology
The development of the disease is associated with a variety of causes that affect the subcortical ganglia. These include:
- deficiency of enzyme structures;
- poisoning with toxic substances, including medicines;
- encephalitis;
- brain tumor;
- brain injury.
This condition is accompanied by a decrease in the level of catecholamines in the black substance and the caudate nucleus of the brain, which causes disturbances in the extrapyramidal system.
Neurophysiological causes of parkinsonism
Movement control is performed by neurotransmitters, which are biologically active components that transfer momentum between cells. Violation of the balance between these substances leads to a breakdown in the motor functions of the body.
Parkinsonism and is a consequence of this imbalance. In patients with this disorder, the level of excitatory neurotransmitters, namely glutamate, exceeds the level of inhibitory components - dopamine .
That's why the principle of treating the disease is to artificially maintain the proper balance of neurotransmitters.
Symptoms of
Typical disorders of movements in parkinsonism will be:
- Tremor or tremor. This is perhaps the most frequently mentioned feature, although experts say that it does not always appear. Tremor occurs as a result of rhythmic contraction of muscles. When performing directed movements, the tremor may disappear or become less pronounced.
- Stiffness of muscles or rigidity. This symptom is associated with an increase in muscle tone in the limbs. Also, this symptom can be manifested in stooping a person's posture. Often, stiffness causes pain, which causes a person to see a doctor. If the doctor does not reveal other manifestations, he can put the wrong diagnosis - for example, rheumatism.
- Slow down and reduce the number of movements. The patient may experience great difficulties with the onset of movement. In addition, others may notice a depletion of the gestures and facial expressions of a person. As the disease develops, a person may experience difficulties with changing the position of the trunk in a dream.
- Imbalance or postural instability. In this disease, postural reflexes may be completely absent or substantially weakened.
People with Parkinsonism often lose their balance and even fall. This symptom is considered one of the main ones in this pathology.
A patient with Parkinson's disease describes his feelings, symptoms and tells about what treatment was prescribed in a simple polyclinic:
Classification of parkinsonism types
Vascular parkinsonism
It is accompanied by speech disorders, coordination of movements, swallowing and other signs. In this case, there is no tremor of rest.
At the heart of the development of this condition may be a violation of cerebral circulation. The distinctive symptoms of this form of parkinsonism include:
- Symmetry Symptoms;
- no tremor;
- predominance of traits in the legs and axial divisions;
- no worsening with the withdrawal of dopaminergic agents;
- change gait at the onset of the disease.
This disease develops as a result of the appearance of cerebrovascular disorders. It can be:
- Defeat of small arteries of the brain.
- Brain lesions of a cardiogenic nature.
- Violation of the operation of large arteries of the brain.
For the purpose of diagnosis, magnetic resonance imaging of the brain is performed. Typically, this disease has a characteristic clinical symptomatology, and all changes can be easily identified through this type of study.
Neuroimaging may also be required - this is required in order to exclude the presence of a tumor. Modern treatment of vascular parkinsonism includes a set of measures aimed at preventing further damage to the cerebral vessels.
The most commonly prescribed anti-Parkinsonics:
- dopamine receptor agonists;
- amantadine;
- preparations of levodopa;
- MAO-B inhibitors.
Treatment of this type of parkinsonism is carried out in many clinics in Russia and other countries. Among the domestic institutions can be identified "Euromedprestige" and "Clinic of Rehabilitation neurology."
As for other countries, it is worth paying attention to Israeli clinics - Shiba Medical Center, Hadassah Hospital, Assuta Clinic. German clinic Friedrichshafen is successfully treating this pathology successfully. And in the Czech Republic you can go to the Neurology Clinic.
Toxic Parkinsonism
Develops as a result of poisoning with toxic substances. Often to its appearance leads to the ingress of carbon monoxide, manganese, lead, carbon disulphide, ethyl or methyl alcohol.
Drug Parkinsonism
To his appearance leads to the use of various medications - for example, neuroleptics.
Posttraumatic Parkinsonism
This form of pathology develops as a result of damage to brain structures - very often it occurs in boxers. One of the varieties of the disease is the Martland syndrome, which causes dystrophic changes in the brain.
Postencephalitic parkinsonism
This species is characterized by an infectious origin. Its development is associated with disorders in the upper brain stem in the case of epidemic encephalitis. And the distinctive symptom of this parkinsonism is oculomotor disorders.
Juvenile Parkinsonism
This term means a special form of primary parkinsonism, which is distinguished by a hereditary origin. Most often it occurs in women and has an autosomal recessive type of inheritance.
For treatment of parkinsonism in medicine, a number of drugs have been developed and successfully used. The scheme of treatment of the disease is chosen depending on the individual characteristics of the patient.
In 80% of cases, there is primary( idiopathic) Parkinsonism - Parkinson's disease. About the symptoms and signs of Parkinson's disease, its differences from other types of parkinsonism you will learn from this article.
Parkinson's disease is a progressive pathology of the nervous system. Is it possible to cure this disease or patients waiting for the inexorable extinction of mental and physical activity read in the article http: //gidmed.com/ bolezni-nevrologii /parkinsona/ lechenie.html
Manganese Parkinsonism
This syndrome is associated with an increase in the manganese content in the body. Most often, this kind of intoxication is observed in workers engaged in the mining industry, and welders.
Atherosclerotic Parkinsonism
Usually occurs due to diffuse atherosclerotic brain lesions that cause the development of lacunar strokes. This pathology is difficult to treat and in a short time becomes the cause of disability of the patient.
Atypical parkinsonism
It is characterized by:
- rapid development;
- incomplete effect of levodopa preparations;
- atypical for Parkinson's disease manifestations - cognitive impairment, postural disorders, pyramidal signs, autonomic dysfunctions, cerebellar signs, etc.
Timely diagnosis of atypical forms of the disease is very important for choosing the tactics of therapy. In addition, setting the right diagnosis will help to avoid not only ineffective, but even dangerous treatment.
Drugs that increase the risk of Parkinsonism
The development of the disease can provoke such drugs:
- Neuroleptics.
- Drugs that reduce the turnover of dopamine in synapses are alpha-methyldopa.
- Dopamine receptor antagonists - flunarizine and metoclopramide.
- Serotonergic drugs that reduce neuronal activity are fluoxetine.
- The agents that reduce the sensitivity to the dopamine of the postsynaptic membrane are the means of lithium.
- Central sympatholytics, which reduce the reserves of dopamine, are preparations of rauwolfia.
Also on the development of the disease can affect such drugs as amoxapine, diprazine, calcium antagonists.
Parkinsonism is a serious pathology that leads to life-threatening consequences. Despite the fact that the reasons for its development are not fully understood, there are quite effective tools in the arsenal of doctors that help stop the progression of this disease. Therefore, when a disease occurs, you should immediately contact a specialist.
In the video Alexander Misharin, he is 53 years old, 13 of them have a diagnosis of parkinsonism, but he does not give up and looks healthy enough, which is facilitated by physical exercises: