Parkinsonism for dummies
Parkinson's disease is a brain disease accompanied by impaired coordination, tremor and speech disorder. The patient may have one or more symptoms at once.
Stages of Parkinson's disease
There are five stages in the course of Parkinson's disease.
At the very beginning of Parkinson's disease, clinical manifestations are not pronounced. A person can independently perform daily procedures, without paying attention to minor difficulties. Therefore, the first stage often goes unnoticed until the violations become more pronounced.
In the first stage , violations of the following skills appear:
· expression of emotions on the face;
In addition, a slight tremor may appear in one half of the body. At this stage, the attending physician prescribes medications that reduce the severity of symptoms.
Tremors, tremors and stiffness of movements spread to both halves of the body, they become more intense.
It is increasingly difficult for the patient to serve himself at home, in the presence of concomitant diseases and at an older age, it is no longer possible to do without outside help.
Gait and speech disorders are increasing.
In the third stage, the disease progresses markedly. The violations characteristic of the second stage are joined by:
· coordination disorders;
· slowing down movements;
· weakening of reflexes.
At this stage, the risk of falls and injuries increases due to significant violations of body coordination. Independent implementation of simple daily hygiene procedures becomes difficult and almost impossible, the help of a caring person is needed.
At this stage, Parkinson's disease is treated not only with medication, patients are recommended physiotherapy and physical therapy. The effectiveness of therapy varies greatly in each case.
It becomes impossible to perform simple daily manipulations without outside help. The patient is still able to stand on his own, but a walker or other auxiliary devices are already needed for movement.
The fifth and final stage of Parkinson's disease is characterized by the most severe course. It is impossible to stand and move independently. The patient is bedridden, moves only in a wheelchair. To take care of him, someone must always be nearby.
At this stage , there may be:
· no effect of treatment;
· confused consciousness.
Symptoms of Parkinson's disease
Symptoms of Parkinson 's disease include:
· bradykinesia (inhibited movements);
· uncontrollable tremors and tremors;
· stiffness in the limbs;
· lack of coordination;
· instability in the standing position.
In addition to motor disorders in Parkinson's disease , there may be:
· impaired sense of smell;
· visual impairment;
· memory loss and slow thinking;
· speech disorders;
· difficulty swallowing.
The symptoms of Parkinson's disease develop slowly, first bringing mild discomfort, and then making independent life impossible.
Scales for assessing the severity of the disease
When managing a patient with Parkinson's disease, the doctor uses special scales to assess the degree of progression of the disease.
Most measurements are based on the assessment of motor disorders. Some scales take into account other symptoms.
Most often in their practice , doctors use two scales:
· Unified Parkinson's Disease Rating Scale (UPDRS);
· Hyun and Yar scale.
Unified Parkinson's Disease Assessment Scale
UPDRS most fully assesses the condition of a patient with Parkinson's disease, in addition to the main symptoms, it takes into account:
· mental health;
· social interaction;
Such a wide range of symptoms makes it possible to assess not only motor disorders, but also the impact of Parkinson's disease on everyday life.
The Hyun and Yar Scale
This scale is a simplified version of UPDRS, it allows you to evaluate only motor disorders associated with the progression of Parkinson's disease.
Motor disorders are assessed in points from 1 to 5, where 1-2 points are initial changes, 3-4 points are moderate, 4-5 points are pronounced.
How does Parkinson's disease develop?
Doctors and researchers adhere to the theory of the progression of Parkinson's disease, known as the Braak hypothesis.
According to this hypothesis, changes begin in several parts of the nervous system at once:
· the nervous system of the intestine;
· medulla oblongata;
· olfactory bulb.
Currently, researchers are trying to use olfactory disorders to detect Parkinson's disease at the earliest stage.
Further, according to Braak's hypothesis, the disease spreads to the black substance of the brain and the cerebral cortex, causing characteristic motor and non-motor disorders.
Currently, there is no effective drug for the complete cure of Parkinson's disease. Symptomatic treatment can effectively improve the quality of life in the early stages. As the disease progresses, the manifestations of the disease significantly complicate the patient's life, making normal life impossible without outside help.
Parkinson's disease is not a fatal disease, but some symptoms can lead to life-threatening conditions, for example, asphyxia when swallowing is impaired or injuries when falling due to coordination disorders.