Parkinson’s disease is a chronic progressive disease of the central nervous system. Because of this disease, people have movement and speech disorders.
It often also affects people’s mood, behavior, and thinking. We name it after the physician James Parkinson, who in 1817 was the first to describe its symptoms.
Parkinson’s disease is a chronic and slowly progressive disease that affects the central nervous system, causing movement and speech problems.
The disease is difficult to diagnose at an early stage, but there are some symptoms that may show its presence in the body.
The disease develops when the body produces insufficient amounts of dopamine, a chemical responsible for the normal transmission of nerve impulses to the brain, including muscle function and movement of limbs, which determines thinking, emotions, behavior and perception.
Over time, the disease causes a general decline in mental and intellectual levels, which can lead to dementia (dementia), complete physical inability and dependence on others.
Some patients cannot control their movements, consciousness and behavior. Then subconsciously driven manifestations appear: active, even aggressive sexuality, strange, militant and uncritical behavior.
The tremor is mostly at rest and is not permanent at first. You may notice arbitrary finger movements, reminiscent of counting money or rolling bread balls. The tremor of the head is the easiest to follow.
If a person is active, it decreases. Parkinson’s disease most often starts in the average age of 55-60, regardless of gender, but there are cases when brain atrophy is detected in 30-year-olds.
Diagnosis may take several years after the onset of the first symptoms by performing repeated computed tomography, electromyography, magnetic resonance, ultrasonography examinations.
- Handwriting changed
- Impaired sense of smell
- Sleep disorders
- Abdominal disorders
- Tremor of body parts
- Stiffness and slow motion
- A louder voice or face “mask” effect
If the handwriting has been wide but the letters are big, but now it has become small and compressed, it is worth paying attention to.
Many patients in the early stages of the disease become slower to move, causing problems with monotonous work such as typing. If you notice that you no longer smell and before, see a doctor.
Although this is not one of the most common symptoms of Parkinson’s disease, experts point out it is a fairly common phenomenon, which is considered being one of the first symptoms of the disease.
The link between olfactory and Parkinson’s disease is not entirely clear, but one theory is that before moving to the part of the brain responsible for movement, certain substances characteristic of Parkinson’s disease form in the brain centers responsible for olfactory.
If so far your sleep has been peaceful and healthy, but suddenly you constantly wake up, turn around hard, toss your arms and legs, or have talked, there is reason to believe that something is wrong with your health.
Although sleep disorders can even show several illnesses, one of them is Parkinson’s disease. Damage to the brainstem caused by the disease can cause sleep disorders.
Parkinson’s disease alters the autonomic nervous system by disrupting the control of certain processes, such as digestive and intestinal function.
Although constipation is not uncommon, we should take it into consideration if you notice other symptoms, such as sleep disturbances or movement problems.
Experts believe that there is a link between Parkinson’s disease and depression, meaning that many patients have been struggling with depression for several years before experiencing the first symptoms of the disease.
The disease can affect the development of various neurotransmitters – they are chemicals that allow nerve cells to communicate with each other.
We can see mild tremors of various parts of the body after intense exercise, stress, and after taking certain medications, but it should not appear when you are at rest and relaxed.
Doctors emphasize that a slightly trembling finger, thumb, hand, chin, lips or limbs when at rest may show illness. This manifestation can become more noticeable when a person is anxious or stressed.
Pay attention if you suddenly feel unusual stiffness in your joints, accompanied by muscle weakness that does not go away, but complicates daily activities such as walking, brushing your teeth, closing your shirt, or cutting food.
Patients may also stop swinging their arms while moving, and feel heaviness in their feet, which makes it difficult to move.
As the disease progresses, other non-movement-related symptoms appear, which are often underestimated and not attributed to Parkinson’s disease. For example, there may be impotence, difficulty urinating, skin changes, low blood pressure.
Mental problems can start – depression, memory problems, dementia. Various factors cause Parkinson’s disease. Heredity affects every tenth case.
We also consider it that, in certain genetic predispositions, the environment may facilitate the development of the disease, in particular through exposure to pesticides, herbicides and other chemicals used in agriculture.
Some studies suggest that those living in a farming area have a higher risk of developing the disease, but this does not mean that Parkinson’s disease always develops in people who have been exposed to toxic substances.
Most times, the cause of the disease is not really clear. If we specify a specific cause, it is not Parkinson’s disease but secondary parkinsonism. Unlike Parkinson’s disease, parkinsonism does not progress if it eliminates the cause.
They can be very diverse. One reason may be the use of medicines, especially older neuroleptics (blockers of central and peripheral nervous system function).
They prescribe this medicine to treat various mental illnesses. Parkinsonism can also develop after strokes, head injuries, encephalitis, toxic substances.
Changes In Mental State
A patient with Parkinson’s disease often develops various changes in mental status. More common progress:
- Cognitive impairment up to dementia;
- Visual disturbances;
- Obsessive compulsive disorder.
Psychotic hallucinations and nightmares are common in 50% of patients with Parkinson’s disease.
Hallucinations and nightmares are one of the major reasons patients end up in nursing homes and are more often forced to receive inpatient treatment.
Psychosis and dementia negatively affect the quality of life not only of the patient but also of the caregiver.
Treatment for Parkinson’s disease is based on relieving symptoms, but unfortunately no treatment has been found to completely cure the disease. They must be effective, timely and age-appropriate.
Treatment of motor symptoms -Levodopa
The “gold standard” in the treatment of Parkinson’s disease. The medicine works by a mechanism that allows brain neurons to convert levodopa to dopamine, thus preventing the dopamine deficiency and symptoms caused by Parkinson’s disease.
Although levodopa is the most effective drug to treat motor symptoms of Parkinson’s disease,
sometimes, such as mild symptoms and characteristic tremor is the only or most visible symptom in patients <60 years of age, other drugs (eg MAO-B inhibitor amantadine, anticholinergic medication, beta-blockers or dopamine agonists)
to avoid the complications of motor symptoms associated with levodopa.
There is evidence to support the use of levodopa and dopamine agonists in all stages of Parkinson’s disease when there are motor symptoms. Dopamine agonists and drugs that block dopamine metabolism are effective in treating motor symptoms.
Dopamine agonists act directly on dopamine receptors and mimic the endogenous neurotransmitter, thereby stimulating those parts of the brain that are affected by dopamine deficiency.
Their action is to suppress the formation of Catechol-O-Methyl Transferase (COMT). COMT inhibitors are the latest class of drugs for Parkinson’s disease.
These medicines do not have a direct effect on the symptoms of Parkinson’s disease, but are used to prolong the effectiveness of levodopa by blocking its metabolism. The most commonly used agents are entacapone and tolcapone.
MAO-B inhibitors work to prevent dopamine from being degraded in the body by blocking the action of an enzyme in the brain that weakens levodopa. This class of drugs includes rasagiline, selegiline.
They base anticholinergic drugs on the suppression of glutamate (NMDA or non-NMDA) receptors and muscarinic cholinergic receptors. They do not act directly on the dopaminergic system, but they reduce the activity of acetylcholine.
Examples of drugs that block muscarinic receptors are benztropine, procyclidine, and the glutamate receptor blocker is memantine.