Parkinson's Disease

WHAT IS PARKINSON’S?

Mostly on one side of the body, slowing the rate of movement (bradykinesia), usually seen while at rest, shaking (tremor), irregular contractions of muscles in the body that occur as a result of a feeling of stiffness (rigidity), and emerging with postural disorders in Parkinson’s disease increased over the years and starts on one side of the body to the other side of the body and the findings passes. In order to cope with the disease, drug therapy is applied first. Surgical treatment is preferred if there is no response to this treatment or resistance to treatment develops over time.

Parkinson’s is among the groups of diseases called progressive, i.e. Decongenative, of the brain, which are mostly seen in people over the age of 60. Dopamine is one of the substances (neurotransmitter) that provides electrical communication between brain cells Decently. The region of the brain that works with dopamine is the region that allows our movements to be performed according to the purpose, that is, in a sense, provides the fine-tuning of our movement. Parkinson’s disease occurs with the loss of 60-80 percent of the cells that communicate with dopamine. Parkinson’s findings show differences in patients, especially during the initial period.

HOW IS PARKINSON’S DIAGNOSED?

The diagnosis is made by the patient’s clinical history and neurological examination. It should always be borne in mind that some medications may have side effects that mimic Parkinson’s disease, called Parkinsonism. Blood biochemistry and MRI imaging also have diagnostic values. Nowadays, parkinson’s can be diagnosed even at an early stage by Dat-Scan method. With this technique developed in recent years, it has made early diagnosis very easy. This method has been used in a limited number of centers in Turkey since 2018 with the approval of the Ministry of Health. Dat-Scan is an imaging method that shows dopamine cells that remain active in the brain by marking dopamine with a radioactive substance. Thanks to the new screening method DAT Scan, it can be easier to understand whether Parkinson’s is due to the slowdown that occurs with normal aging or due to different diseases. In addition, with the DAT Scan method, predictions can be made about the course of Parkinson’s disease, that is, whether it will progress slowly or quickly.

WHAT IS THE TREATMENT FOR PARKINSON’S?

Drugs are primarily used in Parkinson’s treatment options. Surgical treatment can be performed in patients where the expected response cannot be obtained with medications, or in cases where the usefulness of medications decreases over time. Drug therapy is aimed at increasing the dopaminergic transition, which is reduced in the brain. So the Parkinson’s drug is aimed at increasing dopamine. For this purpose, drugs that increase the amount of dopamine in the brain are used in treatment. However, in a way that we do not know the exact cause, fluctuations in the form of short-term excessive mobility, complete unresponsiveness (off period) or involuntary movements (dyskinesia) may occur in patients with long-term and/or high doses of Parkinson’s drugs. In order to delay these conditions, which can occur on average between 5-7 in patients using these drugs, the patient should be given the lowest dose that can be received Decently at the beginning of the discomfort. If the patient is under 65 years of age and does not have dementia, treatment can also be started with ‘dopamine agonicides’ that mimic the effect of dopamine, or it can be used in October as an adjunct to treatment. If there are complaints of tremor, dementia, depression, sleep disorders, other treatment strategies can be planned for these complaints. A third of the patients are people who have received a good response to medication for many years and can live without significant restrictions in their lives. In some of the remaining group, the response to the drug is limited, and as the dose is increased, side effects and non-response to the drug may occur over time.

Surgery may be resorted to in patients who do not benefit from drug therapy. Especially in patients who have not responded to drug therapy for the last 15-20 years, the surgical option is recommended. The aim is to create a decreased electrical stimulation in the centers related to our movement in the brain by means of a generator located a few cm under the skin on the chest wall. It can be thought of with a pacemaker-like logic. The medical name of the practice is “deep brain stimulation”.