Parkinson Disease

Parkinson Disease


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


What are the risk factors for Parkinson's disease?

  • Advanced age
  • Having a family history of Parkinson's disease
  • Rural life, farm and well water use
  • Pesticides
  • Male gender
  • Head trauma
  • High dietary intake of iron and manganese
  • The white race
  • Animal fats taken with food
  • Obesity
  • Physical and emotional stress

What are the protective factors in Parkinson's disease?

  • Smoking
  • Coffee and caffeine consumption
  • Nonsteroidal anti-inflammatory drug use
  • Antihypertensive drug use
  • Alcohol
  • Excessive physical activity

Although experiments on animals for Parkinson's disease have determined that nicotine taken due to smoking protects dopamine cells, many harmful and toxic substances other than nicotine in cigarettes cause many other diseases such as cancer and cardiovascular diseases. Smoking has absolutely no place in the treatment of Parkinson's disease.


Parkinson's symptoms
Parkinson's disease is a slowly progressive neurodegenerative disease. The onset is characterized by signs of movement system dysfunction. It shows symptoms such as decreased mimics, monotony and deterioration of speech, slightly tilted body position, slowing of 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. 4 to 6 years before the onset of symptoms, Parkinson's patients are mistakenly misdiagnosed because of depression, shoulder, neck and arm pain. The most common initial symptom of the disease is the absence of tremor in one hand and fingers at rest and the absence of arm sway accompanying walking on the same side. Tremors may rarely begin in the feet, jaw, and tongue. Slowing of movements without tremor may also be an initial sign. Decreased arm swing movement accompanying walking, decreased dexterity in the affected hand, reduced writing, poor facial expressions, stiffness in one leg while walking, and standing dragging are among the first symptoms. Symptoms that first appear during the disease process usually spread to other extremities on the same side and appear in other extremities as the disease progresses. In cases that start in the upper extremities, the spread of the disease is seen to follow the order of hand, arm, foot, leg, face, speech and swallowing. In cases where the symptoms start in the lower extremities, there is an order of influence in the form of feet, legs, arms, hands, face, voice and swallowing disorders. 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. There is often a tremor in one extremity. Only the relatives of the patient notice the deterioration in mimic, posture and gait.
Stage 2: Symptoms appear on both sides at this stage. There is very little disability. Posture and gait are affected.
Stage 3: Significant slowdown in trunk movements, imbalance and falling. Moderately diffuse dysfunctions are observed.
Stage 4: Symptoms are severe at this stage. The patient can walk, albeit with difficulty. There is slowness and stiffness in movements. Tremors may be less than in previous stages. This group of patients cannot live alone unaided.
Stage 5: The patient is bed- and wheelchair-bound and needs constant care.




Parkinson's treatment
Parkinson, one of the many diseases caused by the loss of cells 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 physician follow-up. Since Parkinson's is a disease that reduces 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 extremely important for treatment to consult a neurologist as soon as the symptoms of the disease appear. Early treatment slows the progression of the disease and improves the patient's quality of life. According to the stages of the disease, many different treatment methods can be applied by the specialist physician. First of all, it is aimed that the patient can continue his/her 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, deep brain stimulation known as a brain pacemaker, which can be applied in some patients, improves the typical symptoms of the disease and increases the quality of life. The chance of success increases when deep brain stimulation, which consists of stimulation electrodes roughly placed in the relevant areas of the brain and a battery placed under the skin in the chest or abdomen, is performed by an experienced team in selected cases with the correct diagnosis. In addition, body exercises that Parkinson's patients will do in addition to drug treatments will also provide advanced benefits. It is recommended to exercise in line with the patient's needs and mobility, as exercises have a positive effect on muscle stiffness and slowness of movement, as well as making the person feel better. Particularly, Parkinson's patients in the early stages can exercise easily since their movements are not restricted yet. These movements allow people to increase their mobility, encourage them for a more active life and make it easier to move. 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 create fatigue, on the contrary, they provide vitality. These exercises consist of many movements such as walking, buttoning and opening, mimic movements, getting out of bed and lying down, dressing, voice, breathing, chin and lip exercises for the correction of speech disorders.

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