Parkinson

Parkinson's Disease

What is Parkinson's Disease

Parkinson's Disease (PD) is one of the most common neurological disorders, affecting approximately 1% of the people above 60 years, causing progressive disability. The two basic neuropathological findings in Parkinson's Disease are the loss of dopaminergic neurons of the substantia nigra and the presence of luteums and Lewy’s axons.

Is there a therapy/treatment for Parkinson's Disease?

Until today there is no treatment capable to stop the progression of the disease. There is however a treatment capable to slow down the progression of the disease and to deal with its symptoms.

Which are the first symptoms of Parkinson's Disease?

The most common symptoms which appear initially to people who suffer from the disease are the following:

  • Tremor
  • Reduced skill in sensitive moves
  • Reduction in the sound of the voice
  • Reduced face expression
  • Sleeping disorders
  • Reduced smell
  • Function disorders of the autonomous neurological system (i.e, constipation, increased or reduced perspiration,  sexual dysfunction, sebum dermatitis)
  • General weakness feeling, malaise/discomfort or easy fatigue/tiredness
  • Depression or anhedonia
  • Slow thinking

Which are the characteristics of the mobility symptoms in Parkinson's disease?

  • Typically the mobility characteristics start asymmetrically
  • The most common first symptom is the tremor ta rest on the upper limb
  • During the disease the patients show progressive dyskinesia, stiffness and walking disorders
  • Standing position progressively turns to convex and walking takes place with small steps
  • In an advanced stage balance disorder appears as well

How does the diagnosis takes place?

Parkinson disease is a clinical diagnosis. There are no lab tests and bio indicators confirming the diagnosis. The imaging findings of the brain in the CT scan and the MRI are not indicative of the disease.
Consequently the diagnosis of the disease is based on the case history and the clinical test. For the diagnosis 2 out of the 3 basic symptoms is required:

  • Tremor at rest
  • Stiffness
  • Dyskinesia

Therapeutic approach and medication

The therapeutic approach is based on the symptomatic treatment of the mobility symptoms. With the current data managing the disease is successful for many years.

In the last few years we also have drugs on our disposal which can deal with or delay non mobility symptoms such as fatigue, erectile dysfunction and constipation.

Also in our days surgical techniques have been developed, regarding the implantation of devices based on the electric stimulation of basal brain ganglions with very good results.

 Physical Medicine and Rehabilitation

The Parkinson's disease patients can truly benefit by an intensive rehabilitation program based on physiotherapy, occupational therapy and speech therapy. The rehabilitation program aims at improving walking, balance and flexibility, increasing aerobic skill and eventually the functional independence.

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