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Parkinson's Disease

The Parkinson’s Disease (Ideopathic Parkinson Syndrome) is one of the most common movement disorders and usually manifests after the age of 50. Parkinson’s is a very complex disease; it leads to a reduction of nerve cells in the Subsantica nigra, a region of the brain. This reduction leads to a deficiency of dopamine. Because of that deficiency the symptoms of the Parkinson’s Disease are manifesting. The cause of Parkinson’s Disease is not known so far, even though many speculations have been made. In Austria are about 20.000 people suffering from Parkinson’s; in Germany there are 250000-280000 people diagnosed with this disease. Men are more often affected by Parkinson’s than women.


Symptoms of the Parkinson's Disease

In the beginning most symptoms are non-motor, like reduced intestinal activity, problems with sleeping and/or depressions. Early motor symptoms are e.g. a blurred handwriting, leg cramps, shaking of the upper extremities and pain in the muscles of the back and shoulders.

In the adjacent picture you see an illustration of the typical body posture of Parkionson's patients. With the ongoing of the disease patients get a more stooped posture, body and head bend forward. Also the arms and legs are bend.

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The four main symptoms:

 

1. Slower movements (Bradykinesis, Akinesis):

At first the slower movements are perceived as a light weakness, over the course of the disease the movements get much slower and restricts the patient. Not only the body but also the facial muscles are affected which often leads to a frozen facial expression.

 

2. Muscle stiffness (Rigor):

The stiff muscles lead to limited mobility and often cause pain that feels like muscular tensions.

 

3. Shaking in rest position (Tremor):

A common symptom is the so-called rest tremor. Rest tremor is often characterised by shaking hands (the upper limbs are affected, sometimes also the head and more uncommonly the legs). Most of the time the tremor manifests more forcefully in one side of the body. Typical for the rest tremor is the fact that it disappears when a movement is implemented.

 

4. Postural instability (problems with posture, standing and walking stability):

Postural instability is characterised by a forward bent body; while walking patients only make small steps. In the later course of the disease the postural instability can cause falling.


Treatment of Parkinson's

Parkinson’s is not curable. With medical and non-medical therapies, the symptoms can only be reduced and the quality of life for patients can be improved. Today there are many medications that treat Parkinson’s symptoms; the primary goal of these medications is the pharmacological replacement of dopamine. What medication and which dose is chosen depends on the age of the patients, accompanying diseases and the main symptoms.

In the first years of the disease the medication has good effects on the symptoms and even if the medication is stopped for some days the positive effects do not leave. These first years of the disease are called “Honeymoon Phase”. In the further course of the disease the response to the medication is not that positive anymore, the effects do not last as long as in the Honeymoon Phase; the dose of the medication needs to be higher. The most common medication for Parkinson’s Disease is Levodopa (L-Dopa), a precursor of dopamine that is transformed into dopamine in the brain. Other medications that are often used are the dopamine agonists; these substances imitate the effects of dopamine on the brain. Which medication is chosen for a patient always needs/has to be discussed with the attending doctor.

 

 

1 Quelle: Website the Parkinson Selbsthilfe www.parkinson-sh.at, visited on 06/04/2018

2 Quelle: Website the Parkinson Selbsthilfe Deutschland http://www.parkinson-gesellschaft.de/aktuelles/36-von-der-forschung-in-die-klinik-die-deutsche-parkinson-gesellschaft-mit-neuer-praesenz-im-web.html, visited on 06/04/2018



 

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