Parkinson's disease is a neurodegenerative brain disorder that affects the nerve cells in the brain that produce dopamine..
The motor symptoms of the disease are the result of the death of pigmented neurons in the substantia nigra, a region of the midbrain. This results in the lack of sufficient dopamine production in these areas. The reason for this cell death is poorly understood, but it involves the accumulation of proteins in Lewy bodies in neurons..
The cause of Parkinson's disease is unknown, but it is believed to involve both genetic and environmental factors. People with an affected family member are more likely to acquire the disease. There is also an increased risk in people who have been exposed to certain pesticides and among those who have had severe head injuries.
Most people's symptoms take years to develop, and they can live with the disease for many years. After diagnosis, treatments can help relieve symptoms, but today there is still no cure for this terrible disease..
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The symptoms of Parkinson's disease differ from person to person. They also change as the disease progresses..
During the early stages of the disease, there may be no warning signs and no symptoms. Symptoms generally develop slowly and often go unnoticed by family, friends, and even the person who has them..
So symptoms are unique to each individual, and the progression of symptoms also varies from person to person, although five stages of Parkinson's have been described that can help understand the changes that occur over time. Some people can take 20 years to go through all the stages. In others, the disease progresses more rapidly.
Besides tremor, the most common symptoms include:
Tremor is usually the first symptom for people with Parkinson's disease. At first, the tremor may appear in only one arm or leg, or on only one side of the body, and occurs when you are awake, sitting, or standing (resting tremor), and improves when that part of the body is moved. The tremor can also affect the chin, lips, and tongue. As the disease progresses, the tremor can spread to both sides of the body. But in some cases the tremor stays on one side only. Emotional and physical stress tend to make the tremor more noticeable. Sleep, complete relaxation, and intentional or action movement often reduce or stop the tremor..
One of the most common early symptoms of Parkinson's is a reduction in the swing of the arms from one side when walking. This is caused by muscle stiffness. Stiffness can also affect the muscles of the legs, face, neck, or other parts of the body. This can make the muscles feel tired and sore..
It is a slowness in voluntary and involuntary movements, but mainly difficulty in starting and finishing them. For example, it may be difficult for you to get out of a chair or roll over in bed..
It may be more difficult to speak and swallow. People with these symptoms may choke on food, cough, or drool. Speech becomes smoother and more monotonous. Loss of movement in the muscles of the face can cause a fixed, empty facial expression, often called the "Parkinson's mask."
A person with this disease is likely to walk with small steps, feet together, bend forward slightly at the waist, and have trouble rolling over. Balance and posture problems can cause frequent falls. However, these problems generally do not appear later in the disease..
It is a sudden but brief inability to move. Most often it affects walking. After a while it disappears.
It is a state in which the handwriting of the patient becomes smaller and more illegible.
Depression can be caused by illness or by a reaction to it. Some sufferers become depressed when diagnosed. Signs of depression include impaired sleep, memory, appetite, interest in social or sexual life, loss of energy or motivation for certain things, and a negative self-concept. It is difficult for the patient to accept their condition and is angry about their limitations.
Anxiety appears in any stressful situation, due to not being able to perform the daily tasks to which he was accustomed. Anxiety can even lead to increased instability, shortness of breath, and excessive sweating. Relaxation techniques are helpful to prevent this from happening..
Cognitive alterations often include difficulties in concentration, memory, slowed thinking, the ability to plan complex tasks or to perform several tasks at the same time.
Difficulties sleeping are due to anxiety, pain, or muscle stiffness. It is essential that the patient sleep well and get a good rest because restful sleep reduces the symptomatic parkinsonian effects. Tiredness is a very common state of physical and mental exhaustion in parkinsonian patients. It can be a consequence of medications, depression, or the extra effort required to perform daily tasks and cope with the symptoms of the disease. This can be improved with the appropriate medication if the cause that causes it is identified..
Sometimes patients report pain in the legs from cramps, cold, burning or numbness and headache (headache) or lower back pain.
It is the loss or decrease of the sense of smell.
The confusion and hallucinations that may appear are side effects of the parkinsonian medication and not of the disease itself.
A small number of people have symptoms on only one side of the body, and they never progress to the other side.
During this initial stage, the person has mild symptoms that generally do not interfere with their daily activities. Tremors and other symptoms of movement may appear on one side of the body only. Friends and family may notice changes in posture, walking, and facial expressions.
In the second stage of Parkinson's, symptoms begin to get worse. Tremor, stiffness, and other movement symptoms affect both sides of the body. Problems with walking appear and poor posture can become apparent. At this stage, the person is still able to live alone, but performing day-to-day tasks becomes more difficult and may take longer..
Stage three is considered the intermediate stage in the progression of the disease. Loss of balance and slowness of movement are characteristic of this phase. Falls are more common. Although the person remains totally independent, the symptoms significantly alter the activities of their daily life, such as dressing and eating.
During this stage of Parkinson's, the symptoms are already severe and very limiting. They can stand unaided, but they need someone to help them or a walker to get around. The person needs help with activities of daily living and is not able to live alone.
This is the most advanced and debilitating stage of Parkinson's disease. Stiff legs can make it impossible to stand or walk. The person requires a wheelchair or bedridden. Permanent attention is required for all activities. The person may even experience hallucinations and delusions. While the fifth stage focuses on motor symptoms, there are many important non-motor symptoms as well..
Unfortunately, there is currently no cure for Parkinson's disease. At present, the treatment can be of three types (although combinations are viable): pharmacological, surgical and rehabilitative.
The drugs used in the treatment of Parkinson's disease are the so-called anti-parkinsonian drugs, which try to temporarily restore dopamine in the brain or mimic the actions of dopamine.
However, none of the drugs used in the treatment of Parkinson's disease acts on the progression of the disease. Currently, the most widely used drugs are levodopa and various dopamine agonists, although others such as selegiline (an MAO-B inhibitor), amantadine (a dopamine releaser) or benzatropine (a muscarinic receptor antagonist) are also relevant. acetylcholine).
As the disease progresses and neurons continue to lose, these drugs become less effective, while at the same time producing side effects such as involuntary writhing movements..
Diet and some forms of rehabilitation have shown some efficacy in improving symptoms.
Years ago, surgery began to be used to place microelectrodes to achieve deep brain stimulation and thus try to reduce motor symptoms in the most severe cases, when medications were ineffective. But the problem was that surgical interventions were not always successful and serious complications were not uncommon..
The emotional support of the people around the patient is essential and a key component in the care of Parkinsonian patients as it provides numerous benefits.
As it is a progressive disorder, symptoms gradually worsen over time. In general the symptoms are aggravated by stress and emotional situations that cause anxiety. The psychological part is very important. Symptoms usually improve with rest, sleep, and relaxation techniques or any strategy to control stress and anxiety are used..
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