Parkinson’s Disease (PD) is one of the most common and progressive neurological diseases that occur as a result of the loss of dopamine-producing cells in the brain that play a role in the regulation of movement.
Although the risk of PD before the age of 50 is low, it increases gradually over the years.
Among Parkinson’s patients, 10-15% have a family history. A group of genes that cause PD has been discovered. In our country, some of these genes can be screened.
Factors that increase the risk of PD include male gender, farming, exposure to pesticides and metals, living in rural areas, head trauma, and stress.
Since the initial symptoms of the disease are insidious, it is often associated with the normal aging process, depression, or joint diseases. It takes 4-6 years before the classic symptoms appear.
Patients most commonly consult with resting tremors in the hand or fingers. This tremor may rarely begin in the feet, head, jaw, or tongue.
The slowness of movement without tremors may also be an early symptom. It may manifest as a unilateral decrease in arm sway while walking, a decrease in dexterity, a reduction in writing amplitude, reduced facial expressions, and stiffness in one leg or foot-dragging while walking. In young patients, unilateral foot dystonia (involuntary bending of the foot, twisting) that becomes evident during walking may rarely be the first symptom.
As the disease progresses, the first symptom usually spreads to the other limb on the same side, and over the years it also passes to the opposite side. Apart from this, it is also possible to encounter different onset types and progression processes.
Besides movement-related symptoms, Parkinson’s patients may also have symptoms related to other systems.
As sensory symptoms, sensations such as pain, tingling, burning, numbness, and coldness can be observed.
As a result of the autonomic nervous system being affected, symptoms such as orthostatic hypotension (low blood pressure when standing up), the need to urinate frequently, stiffness during urination, nausea, abdominal swelling, constipation, excessive salivation due to the accumulation of saliva in the mouth, sexual dysfunctions, excessive sweating and edema in the legs can be seen.
In addition, 40-50% of Parkinson’s patients may have depression and anxiety disorders. Psychiatric symptoms other than these usually manifest as side effects of treatments. These include vivid dreams, hallucinations, delusions, mania, increased sexual desire, and impulse control disorder.
Dementia develops at a rate of 40-70% during the PD process. However, patients and their relatives often neglect the symptoms related to mental functions.
Symptoms such as difficulty falling and staying asleep, excessive daytime sleepiness, and REM sleep behavior disorder (RBD), which is characterized by talking during sleep, restlessness and fighting-like behaviors, may also be seen in Parkinson’s patients.
The diagnosis of PD is based on clinical observation. Diagnosis can be made with a detailed anamnesis and physical examination. Blood tests and brain imaging are performed to exclude other conditions that may cause similar complaints.
PD treatment is mostly aimed at reducing the patient’s complaints. No treatment method has yet been found to stop the disease or prevent its progression. It is aimed that the patient can continue the activities of daily living. The primary treatment method is medications. In the treatment of advanced PD, surgical treatment can be applied along with medications.
What is Parkinson’s Disease?
Parkinson’s disease is a disease caused by the reduction of dopamine-producing brain cells. Certain brain cells produce dopamine, and damage to these cells results in Parkinson’s disease. Dopamine provides communication between body movements and brain neurons. Cells that synthesize dopamine are located in a region called the substantia nigra. When cells in the substantia nigra are damaged, dopamine synthesis and release are also adversely affected.
The destruction of dopamine production in Parkinson’s disease causes weakening of body control, slowing of movements, and stiffness in the muscles. In short, all symptoms occur with dopamine deficiency. Symptoms of the disease are usually seen in people over the age of 40. However, it is more common in men than women. Moreover, people with a family history of Parkinson’s disease are at a higher risk of developing this disease.
What Kind of Disease Is Parkinson’s?
The disease was first described in 1817 by James Parkinson. It is known as shaky palsy. Parkinson’s disease occurs when dopamine neurons are damaged. It is defined as a degenerative disease and is not very obvious at first. Hence symptoms manifest themselves over time, and Parkinson’s has an extremely slow progression rate. In most patients, the symptoms manifest themselves in one part of the body and gradually move to the other part.
What Is The Age Range For Parkinson’s Disease?
The age range for Parkinson’s disease is usually 40 – 75. However, the disease is often observed in people over 60 years of age. In addition, only 5% to 10% of patients are between the ages of 20 and 40. The severity of the disease varies from person to person. The incidence is higher in men compared to women. Parkinson’s disease has a different tendency to spread according to countries. Familial Parkinson’s disease is also seen in exceptional cases.
What Causes Parkinson’s Disease?
Parkinson’s disease occurs when the dopamine-producing cells of the brain are damaged and hence unable to release this substance in sufficient quantities. In other words, the cause of Parkinson’s disease is dopamine deficiency. The cause of cell loss is genetic factors or chemicals. Some drugs can cause dopamine-producing cells to be reduced and damaged. Patients usually come with complaints about movement control, but in addition to this, weight loss and sleep disturbances are also observed.
What Are the Symptoms of Parkinson’s Disease?
Tremors are the first among the symptoms of Parkinson’s disease. Tremors are observed in almost 80% of patients. The tremor usually manifests itself in one part of the body; in the hand or in the foot. Tremors can be in a single finger, as well as in all limbs. For example, many patients also have tremors in the jaw, lips, and tongue. Stress and mental activities are factors triggering tremor severity.
Muscle rigidity and stiffness are also seen in Parkinson’s disease. Stiffness is most often observed in the ankles, elbows, and knee joints. Patients describe stiffness in the muscles as pain, cramps, and stinging sensations. In short, we can list the general symptoms of Parkinson’s disease as follows;
- Tremor (shaking),
- Rigidity (stiffness),
- Impairment of motor control (bradykinesia),
- Difficulty standing (postural instability).
How Does Parkinson’s Disease Affect Daily Life?
Tremors are the first symptom of Parkinson’s disease. Therefore, at first, patients face tremor problems such as uncontrollable tremors of the thumb, trembling of the chin and lips, twitching of the leg muscles. They also have difficulty continuing or initiating movement. People with Parkinson’s disease often try to walk with short steps and have pain in the body as their muscles become stiff. In addition, patients often get tired while speaking and use facial expressions less frequently.
Parkinson’s Disease: Other Symptoms
Parkinson’s disease stages have specific symptoms. These symptoms usually become more and more severe in the form of tremor, movement disorder, posture disorder, and speech disorder. However, in addition to all these, there are also side symptoms of the disease. Some people with Parkinson’s disease also complain of constipation. Moreover, depression, urination problems, low blood pressure are among the symptoms. In the advanced stages, a decrease in mimics and a more serious facial expression are observed. In addition, difficulty in swallowing is among the consequences of the disease.
What is the Treatment for Parkinson’s Disease?
Although there is no definite treatment for Parkinson’s disease yet, intensive studies are ongoing in this field. The cause of the disease is the impairment and loss of dopamine cells. Therefore, the amount of dopamine needs to be regulated throughout the treatment process. Medications often cause an increase in decreased dopamine or mimic the effect of dopamine. Others prevent the breakdown of dopamine and increase the dopamine effect even more.
Recent studies determined that vitamin E in the body reduces the severity of the disease. At the same time, vitamin C positively affects the production of L-dopa, thanks to its antioxidant properties. On the other hand, surgical methods are also used if drug treatment is not considered sufficient for Parkinson’s disease. Some symptoms of the disease have a severe course in particular and surgical intervention is performed when patients cannot bear these pains.
What are the Treatment Methods for Parkinson’s Disease?
Treatment methods for Parkinson’s disease can be listed as follows;
- Stereotactic Method: It is usually applied to patients with severe tremor symptoms. However, this method may not eliminate other symptoms of the disease.
- Pallidotomy Method: With this method, muscle stiffness and tremor are greatly reduced. It also has a positive effect on gait and speech disorders.
- Battery Method: The part of the brain where dopamine-producing cells are located is stimulated with small electrodes. Battery application, though an expensive method, is often preferred because it does not cause brain damage.
How Are Parkinson’s Patients Diagnosed?
There is no test method to identify Parkinson’s disease. In other words, neurologists can diagnose the disease with blood tests and brain scans based on Parkinson’s symptoms. Parkinson’s symptoms are almost the same in both young and old age. In general, neurologists diagnose with the following methods;
- A detailed physical examination and medical history,
- All treatments received in the past to identify drugs that may cause Parkinson’s disease,
- Examination of agility of arms and legs; balance and gait disorders.
Surgical Treatment of Parkinson’s Disease
Parkinson’s patients are usually treated with drugs in the initial stages. Thanks to the drug, dopamine is imitated, or its breakdown is prevented. However, Parkinson’s surgery should be performed in stages where drug therapy is not effective. The aim during surgery is to replace dopamine or to prevent its decrease. The surgery is performed by neurology and neurosurgery specialists. Failure to respond to medical treatment or the occurrence of side effects leaves no choice but surgical intervention.