Parkinson’s disease: see symptoms, treatment, causes and more

The term parkinsonism refers to a group of several diseases that have symptoms in common and that are associated with other neurological manifestations or not. Among these diseases, there is Parkinson’s disease (PD), probably the best known of this group. It is named after the first doctor who described the disease in 1817, Dr. James Parkinson.

According to data from the World Health Organization (WHO), about 1% of the world population over 65 years old has PD. In Brazil, unfortunately there is no exact statistics on the number of sick people, but an estimated 200,000 people are suffering from the disease.

What is Parkinson’s Disease

Parkinson’s disease is a neurological, degenerative, chronic and progressive disease that mostly occurs in people over 65 years of age. Like any cell, neurons also have a certain useful life, however, unlike the others, it does not regenerate over time. This means that, in the case of PD patients, the nervous system suffers degeneration in a region of the brain called the substantia nigra and, consequently, is deficient in dopamine, a neurotransmitter that has the function of controlling the fine and coordinated movements of people.

The disease has no cure and no forms of prevention, but with the forms of treatment available, it is possible to control the symptoms presented by it.

The causes of Parkinson’s disease

As explained, the disease occurs because of dopamine deficiency, caused by the degeneration of neurons located in the substantia nigra. Until today, the effective reason for these neurons to be affected has not been discovered, but some factors may play a role in the formation of Parkinson’s Disease. Check out what they are.

Age

PD is a disease that mainly affects people who are 60 years old or older. Some cases of the presentation of the disease in people under 40, or even 20 years old, are known, but they are very rare.

Family history

It is not a rule, but family members of people who have Parkinson’s disease are more likely to develop the disease.

Male People

According to statistics, the disease is more frequent in men than in women.

Isolated or repetitive trauma to the skull

An example is the activity that a boxer does. As he receives several repetitive traumas in the brain region, dopaminergic neurons, that is, dopamine producers, can be injured.

Contact with pesticides

Certain chemicals can cause the neurological damage that leads to Parkinson’s.

What is the substantia nigra

The nervous system is formed by several cells, called neurons, which are connected through synapses or intercellular spaces. In the case of the substantia nigra, these spaces are located in the midbrain and are made up of a dark pigment, melanin, hence the name.

Recurrent symptoms of the disease

Parkinson’s disease symptoms can be divided into 2 groups: motor and non-motor symptoms.

Motor symptoms of Parkinson’s disease

These symptoms are all related to certain movements performed by the patient and are usually identified by the patient.

Tremors

The typical tremor in Parkinson’s disease is the initial symptom of the disease in 70% of cases. In the early stages of the disease, it goes unnoticed by colleagues and family members of the patient and usually starts on one hand.

As time goes by and PD progresses, the tremor can affect other members of the person. It is more recurrent when at rest and improves when the affected limb is in motion. This is a characteristic that distinguishes Parkinson’s tremor from tremors that occur in other situations.

Bradykinesia

The most disabling symptom of PD, bradykinesia is characterized by slow movements and can present itself in simple activities, such as buttoning a shirt or tying shoes.

The person has difficulty in initiating any voluntary movement, that is, who has control over it. Over time, even the steps are affected, as they become short and slow, in addition to the patient feeling unbalanced while standing.

Rigidity

With the lack of dopamine in the body, the muscles no longer receive the order to relax. Therefore, the stiffness is constant, and may even cause pain, as the range of motion is limited.

One of the most recurrent signs of muscle stiffness is the loss of swinging of the arms when walking.

Other motor symptoms of PD

  • Loss of facial expression;
  • Blink reduction;
  • Speech alteration;
  • Increased salivation;
  • Blurry vision;
  • Micrograph, that is, the person’s handwriting changes and the written letters become smaller;
  • Urinary incontinence.

Non-motor symptoms of Parkinson’s Disease

In addition to the motor symptoms presented by the patient, he may also have several non-motor symptoms of neurological causes, such as:

  • Insanity;
  • Depression;
  • Anxiety;
  • Hallucinations;
  • Sleep changes;
  • Slow reasoning.

How is PD diagnosed?

As there is no specific exam to prove Parkinson’s Disease, the diagnosis is made based on the analysis of symptoms, as well as the patient’s medical history. The specialist doctor you should turn to is the neurologist, only he will be able to tell you whether or not the signs you have are referring to PD.

In addition to the clinical diagnosis, the doctor may also order some tests such as electroencephalogram , computed tomography, magnetic resonance, analysis of the spinal fluid, among others, in order to rule out the possibility of you having other neurological diseases.

Treatment for Parkinson’s Disease

It is important to understand that there is no treatment that will cure the disease, but one that controls the symptoms presented and slows their progress.

As neurons are cells that are not renewed, the only medicine solution for PD was to use medications and surgeries to control its symptoms.

These items, together with physiotherapy, occupational therapy, psychological therapy and speech therapy, have a great effect on the quality of life of the diagnosed person.

Drug treatment

The active substance levodopa is the most suitable for alleviating the symptoms of Parkinson’s disease, as it turns into dopamine in the brain and partially supplies the deficiency of that neurotransmitter. There are several antiparkinsonian drugs that have this substance in their composition and you can check which are below.

Commercial name

Active principle

Sinemet / Cronomet / Prolopa

Levodopa or L-Dopa

Parlodel / Bagren

Bromocriptine

Dopergin

Lisuride

Mirapex

Pramipexole

Celance

Pergolida

Requip

Ropinirole

Akineton

Biperiden

Artane

Triexiphenidyl

Mantidan

Amantadina

Niar / Deprilan / Jumexil / Elepril

Selegiline + L-Deprenil

Tasmar

Tolcapone

Comtan

Entacapone

Azilect

Rasagiline

Neupro

Rotigotine

Stalevo

Levodopa + Carbidopa + Entacapone

Trivastal Retard

Piribedil

Sifrol / Sifrol ER / Livipark / Pramipezan / Stabil

Pramipexole

It is important to note that the Brazilian Ministry of Health makes certain drugs for Parkinson’s Disease available through its Unified Health System (SUS). These drugs are divided into two groups:

Medicines made available by the High Cost Pharmacies of the State Health Secretariats

  • Amantadine 100mg;
  • Bromocriptine 2.5mg and 5mg;
  • Cabergoline 0.5mg;
  • Entacapone 200mg;
  • Pramipexole 0.125 mg, 0.25 mg and 1 mg;
  • Selegiline 5mg and 10mg;
  • Tolcapone 100mg.

Medicines available at municipal health posts

  • Biperiden 2mg and 4mg;
  • Levodopa + Benserazide 200 / 50mg;
  • Levodopa + Benserazide 100 / 25mg;
  • Levodopa + Carbidopa 250 / 25mg;
  • Levodopa + Carbidopa 200 / 50mg.

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Surgery

Certain surgeries can be quite beneficial to some patients and consist of two lesions on the brain: the inner pale nucleus (pallidotomy) or the ventro-lateral thalamus (thalamotomy).

With this procedure, the slowness of movement and the stiffness of the muscles are reduced. However, not every patient can undergo surgery, so the importance of medical monitoring.

Physiotherapy

With this technique, the person diagnosed with PD receives a re-education and maintenance of routine physical activities essential for the improvement of the symptoms presented by the disease. Without physical therapy, muscles tend to atrophy, contract and even shrink.

Occupational therapy

With occupational therapy, the patient will be guided by a suitable professional on how to facilitate day-to-day activities, as well as the behaviors that need to be practiced in order to reintegrate into the professional field.

Psychological therapy

About 90% of people who suffer from PD also suffer from some psychological disorder arising from the disease. The most recurrent disorders are anxiety , mood and depression , and they have a great influence on the quality of life not only of the person, but also of those who live with him. For this reason, it is essential that the patient also has psychological counseling.

Speech Therapy

Some people have impaired speech due to lack of coordination and reduced muscle movement. Therefore, for them, speech therapy exercises directed to speech and voice can help them to converse through understandable and modulated speech.

Complications of PD

As much as the symptoms of Parkinson’s Disease can be treated through the procedures described above, some complications of the disease may appear, but all of them are treatable as well.

  • Memory problems, dementias and reasoning difficulties;
  • Depression and emotional changes, including fear and anxiety;
  • Difficulty swallowing;
  • Sleep disorders;
  • Bladder problems;
  • Constipation;
  • Blood pressure changes;
  • Smelling problems;
  • Excessive fatigue;
  • Sexual dysfunction;
  • Pain in specific limbs or the whole body.

If you have at least two of the motor symptoms of Parkinson’s Disease or know someone who does, make an appointment with a trusted neurologist to see what the diagnosis is. In addition, share this article with your acquaintances, so that information about PD will be more disseminated and, consequently, more people will know its characteristics.

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