Parkinson's Disease: The Disease of Brain Deterioration

Parkinson's disease is a condition that arises from brain cells in the part responsible for producing a chemical called dopamine, which plays a crucial role in controlling body movements, deteriorating to the point where it can no longer produce this substance. As a result, abnormal movements occur in the body. This disease is most commonly found in individuals aged 65-80 years, with men being more susceptible than women, approximately 1.5 times more likely. The progression of the disease is slow, and patients show more noticeable changes over time.

Causes of Parkinson's Disease:

  1. Aging of the brain: A decrease in brain cells that produce dopamine (located in the substantia nigra, a group of dark-colored nerve cells in the central part of the brain that play a significant role in regulating movement) is most commonly observed in individuals aged 65 years and older. This group is considered to have no specific identifiable cause. Additionally, it is the most frequently encountered group.
  2. Neuroleptic or sleep-inducing medications that inhibit or suppress the production of dopamine. However, there are currently newer medications available with fewer side effects, such as calcium channel blockers and anti-vertigo medications.
  3. Blockage of blood vessels in the brain leading to a reduced amount or absence of dopamine-producing brain cells.
  4. Brain-toxic substances, including manganese, insecticides, carbon monoxide, and others.
  5. Brain oxygen deprivation, which can occur during near-drowning incidents, strangulation, or obstruction of the respiratory passages by phlegm or food.
  6. Head trauma or injury that affects the head and brain, as seen in boxing injuries.
  7. Brain inflammation.
  8. Genetic disorders such as Wilson's disease, which involves both liver dysfunction and brain abnormalities due to an excessive buildup of copper in the liver and brain.

Symptoms of Parkinson's Disease:

  1. Tremors: Tremors are typically the initial symptoms of the disease, affecting approximately 60-70% of patients. Resting tremors, occurring mainly when the body is at rest, are particularly pronounced (4-8 times per second). However, the tremors may decrease or disappear when the person is in motion or performing activities. Tremors are most commonly observed in the hands and feet, although they can also occur in the chin or tongue. Tremors are rarely observed in the head.
  2. Rigidity: Patients experience muscle stiffness and difficulty moving their muscles smoothly, often characterized by jerky movements, especially in the arms, legs, and torso, even when they are not actively moving or exerting effort.
  3. Bradykinesia: Patients exhibit slow movements, taking longer than usual to perform tasks. Some individuals may fall due to difficulties with movement, resulting in accidents such as hip fractures or knee injuries.
  4. Abnormal gait: Patients display distinctive abnormal walking patterns, including short shuffling steps initially, followed by progressively longer and faster steps, sometimes unable to stop immediately. The likelihood of falling forward is high. In addition, patients may exhibit a stooped posture, body tilting, arms not swinging, hands close to the body, or a rigid, robot-like gait.
  5. Facial expression: The faces of patients appear expressionless, resembling a masked face. Their mouths may exhibit minimal movement when speaking.
  6. Speech: Patients speak softly, indistinctly, with a hoarse or muffled voice at a consistent volume.
  7. Handwriting: Patients have difficulty writing, and their handwriting gradually becomes smaller and illegible.

Treatment for Parkinson's Disease includes three main approaches:

  1. Medication: Although medication cannot regenerate or replace the brain cells that have died, it can help maintain an adequate level of dopamine in the brain. Currently, the primary medications used are levodopa and dopamine agonists.
  2. Physical therapy: The goal of physical therapy is to help patients return to a life as close as possible to that of a normal individual. It involves exercises to improve walking, such as placing the entire foot on the ground and swinging the arms while walking to assist with balance. It also includes practicing lying down, changing positions, and adopting appropriate postures, as well as speech exercises.
  3. Surgery: Surgery is mainly performed on patients of younger age and with mild symptoms or those experiencing complications from long-term medication use, such as severe tremors or abnormal movements in the arms and legs. Deep brain stimulation, which involves implanting electrodes to stimulate the brain, is commonly used.
  4. Patients with Parkinson's disease require attentive care and support from their loved ones to facilitate physical recovery and maintain their emotional well-being. If you have someone close to you with this condition, it is advisable to seek medical advice for an accurate diagnosis, leading to appropriate and suitable treatment.

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