Parkinsonism
Description:
Understand a number of the diseases of a nervous system proceeding with a tremor as the term "parkinsonism". Distinguish parkinsonism primary. or Parkinson's disease, and secondary, or symptomatic.
Parkinsonism symptoms:
The main clinical display of parkinsonism are the tremor, rigidity and rigidity of muscles, small amplitude and "constraint" of movements, and also disturbance of muscular reflexes. One their first manifestations handwriting disturbance is - the size of letters and clearness of their writing decreases. The gipomimiya - reduction of expressiveness of a mimicry joins; the person becomes masklike, sometimes with the stiffened grimace of surprise or grief. The blink movements urezhatsya considerably a century; the speech becomes muffled and monotonous. Gradually there is a feeling of constraint in all body. Patients a long time can be in poses, not possible for healthy people, for example lie with the head (a symptom of "airbag") raised over a pillow. Considerably gait changes. The first steps are taken with big effort, and then the patient moves the small, tripping short steps which rate gradually increases, the patient as if "catches up" with the own center of gravity. it is also difficult to stop to it, as well as to begin the movement. At the same time paradoxical motive phenomena can be observed: so, the patient who hardly rises from a chair. can easily run up on a ladder, or go, crossing through big obstacles. Temporary "disinhibition" and simplification of the movement can occur under the influence of strong emotions, both positive, and negative - joy or fear.
As other important display of parkinsonism serves muscular rigidity. In process of progressing of a disease it gradually accrues that is followed by development of a characteristic pose with dominance of bending of extremities and trunks: the neck is bent. the golovana is inclined forward, hands are bent in elbow joints and given to a trunk, the back is hunched and legs are slightly bent in hip and knee joints. In attempt to straighten by force of a hand or patient's leg, the strengthened resistance in his muscles, as throughout all extension, and bending is felt. At the same time muscles are unbent and bent as if with small twitchings, as on gears - so-called, a symptom of "cogwheel".
One more characteristic display of parkinsonism is the tremor of all body especially noticeable in hands and the head. Trembling frequency in different parts of a body can be various, but on average - 4-8 fluctuations a second. Usually the tremor is more expressed at rest and considerably decreases when performing purposive movements. The emotional pressure and special attention usually strengthen a tremor. Having begun with fingers of hands, it, in process of progressing of a disease, extends An other muscular groups, taking a mandible, language, lips. lower extremities.
Parkinsonism reasons:
Parkinsonism can be caused by infectious, traumatic damage of a brain, infectious or medicinal influences, and also vascular or tumoral diseases.
Treatment of Parkinsonism:
In treatment of parkinsonism there are no universal schemes. The medical program for each patient has to be individual, however, rationally picked up scheme of treatment will allow to achieve good results throughout a long time. The main drugs, used in treatment, the means operating on various nervous mediators - acetylcholine, dopamine are. Some groups of antidepressants, neuroleptics, cholinolytics treat them. Earlier applied surgical treatment of parkinsonism (operation on destruction of the departments of a brain responsible for muscular rigidity and a tremor) in the present are practically not applied. It is explained by quite successful pharmacotherapy which progress is available in recent years.
