Parkinsonism

General characteristic of a disease

Parkinsonism is a neurologic syndrome which main symptom is disturbance of autokinesias. The syndrome of parkinsonism meets at a number of neurologic diseases and is always followed by trembling of extremities, constraint of muscles, and also slowness of movements of different degree of manifestation.

Depending on an etiology of a disease distinguish primary or idiopathic parkinsonism and a secondary or symptomatic form of a syndrome of parkinsonism. In the first case the disease is caused by gradual death of dopamine neurons in the central nervous system of the person. They are responsible for braking of a physical activity, and their deficit leads to disorder of motive function of an organism.

The secondary syndrome of parkinsonism is provoked by external factors: medicines, craniocereberal injuries, infections, etc.

Parkinsonism – one of the most widespread diseases of people of advanced age. It was described for the first time in 1817 and called in honor of J. Parkinson. After 80 years the syndrome of parkinsonism is diagnosed approximately for every 5th inhabitant of the planet. Increase in life expectancy of people in the developed countries leads to the further statistical growth of number of patients with parkinsonism.

Parkinsonism symptoms

Tremor, it involuntary trembling of extremities – one of the brightest symptoms of parkinsonism. During autokinesia the tremor disappears and appears again at motive passivity of the patient.

One more important symptom of parkinsonism – rigidity, it is constraint of muscles. The disease is shown by the raised muscle tone of skeletal muscles. Because of it performance of any movement demands application of additional efforts. Muscle tension is followed by stoop. There is even an informal name for the patient's pose with parkinsonism syndrome – the "pose of the applicant" caused by change of the reflexes which are responsible for vertical position of position of a body.

As additional symptoms of parkinsonism are considered олиго - and a bradykinesia (slowness and deficit of movements), depletion of gesticulation and a mimicry, balance disturbance.

Primary parkinsonism at elderly people can lead to disturbances of salivation, swallowing, monotony of a voice and in rare instances to dementia (weak-mindedness). The last called parkinsonism symptoms usually are demonstrated at a late stage of a disease.

All symptom complex of a disease results in difficulties when performing everyday occupations, gives a considerable inconvenience and disappears only during sleep the patient.

Types of parkinsonism

According to the standard classification of a disease allocate vascular parkinsonism, and also toxic, medicinal, posttraumatic and postencephalitic types of a disease.

Vascular parkinsonism is provoked by vascular pathologies. Unlike other types of a disease at it the patient has no periods of lack of a tremor. Involuntary trembling of muscles at vascular parkinsonism is provoked by subacute or acute disorders of cerebral circulation. In case of an aggravation of symptoms the disease can develop into a stroke.

Vascular parkinsonism – one of the most rare forms of a disease. Much toxic and medicinal types of a disease meet more often.

Toxic parkinsonism arises against the background of chronic or acute poisoning with heavy metals, poisonous gases or drugs.

Medicinal parkinsonism provokes reception of medicines, for example, of neuroleptics.

Posttraumatic parkinsonism is caused by damages of structures of a brain and occurs most often at boxers. One their subspecies of parkinsonism - Martland's syndrome which is characterized by dystrophic changes of a brain.

Postencephalitic parkinsonism has an infectious etiology. It develops because of damages of an upper brainstem at epidemic encephalitis. One of symptoms of parkinsonism of this look - oculomotor frustration: involuntary rolling of eyes, etc.

Diagnosis of parkinsonism

The tremor and other disturbances of a physical activity are shown already at death of a significant amount of motor neurons. At this stage of a disease diagnosis does not cause difficulties any more. Though not one of symptoms of parkinsonism is not the pathognomonic sign typical only for this disease. Therefore the final diagnosis is established only after long observation of the patient and improvement of its state under the influence of holinoblokator.

Earlier diagnosis of parkinsonism is based on fixing of the minimum changes in a voice of the patient caused by disturbances of functions of muscles of a throat.

Treatment of parkinsonism

The scheme of treatment of parkinsonism is especially individual for each patient. For stopping of a syndrome of a medicinal look there is usually enough cancellation of a course of the accepted medicines. Treatment of parkinsonism of vascular type assumes surgical correction of cerebral circulation by a shunting method.

Part of obligatory drug treatment of parkinsonism of any kind is purpose of L-DOFA-preparatov, cholinolytics, etc. Drug treatment of parkinsonism helps to reduce only manifestation of symptoms of a disease and to slow down its progressing.

Therapy of parkinsonism lifelong therefore development of side effects is possible: locks, dryness in a mouth, the general weakness, disturbance of a cordial rhythm, a dysmnesia and so forth. At insufficient efficiency of conservative treatment of parkinsonism will be applied neurostimulation of a brain. For this purpose under the patient's skin in a breast the neurostimulator which is connected by electrodes to a brain is implanted.

Refer also electroconvulsive therapy, deep stimulation of a brain to radical methods of treatment of parkinsonism of heavy degree magnetic field, and also change of stem cells and embryonal fabrics to the patient.