Parkinson’s disease is a degenerative disease of the nervous system, especially the extrapyramidal system and the autonomic nervous system. Due to degeneration, the stimulus transfer substance (nerotransmitter) Dopamine disappears, resulting in slower stimulus transmission from one nerve cell to another. Parkinson ‘s disease is based on a reduced production of dopamine, the neurotransmitter of the extrapyramidal system. Disturbances also occur in the autonomic nervous system. Certain psychotropic drugs, which disrupt the balance of the transfer substances to the detriment of dopamine (neuroleptics, antipsychotics and certain anti-nausea drugs), give a Parkinson-like picture (parkinsonism).
Parkinson’s symptoms
The extrapyramidal system is responsible for proper muscle tone at rest and during movement. the symptoms that arise from reduced stimulus transmission can therefore be traced back to disturbances in the fundamental tension.
- Crouched posture with bent limbs.
- Stiff stiff motor skills.
- Shuffling steps.
- Start and stop problems when walking.
- Shaking of the hand or arm (tremors) with money counting movements, decreasing with targeted movements and absent during sleep.
- Mask face due to reduced facial expressions and blinking movements of the eyes.
- Small illegible handwriting.
- Monotonous, jarring speech.
- Flexion contractures can easily develop due to the bent posture and limbs.
In addition to disturbances in muscle tone, more or less symptoms of the autonomic nervous system may come to the fore.
- Salivation with drooling and swallowing disorders.
- Unctuous oily skin due to increased sebum production.
- Increased perspiration.
Because of his masked face and clumsy, stiff motor skills, a Parkinson’s patient is inclined to isolate himself. The physical slowness is also reflected on the psychological level, which is why it is often wrongly thought that a Parkinson’s patient is mentally deficient. The disease can be accompanied by psychological images such as violent tantrums and hallucinations, delusions and depression. these can arise from problems with coping with the disease and isolation, but also from further degeneration processes in the brain. The question is therefore whether dementia in an advanced stage of Parkinson’s disease is a consequence of this disease itself, or whether both syndromes are a consequence of progressive degeneration of the brain.
Course and prognosis of Parkinson’s
Thanks to modern medicines, the prospect is no longer as hopeless as it used to be. yet the clinical picture is slowly to rapidly progressive, ultimately resulting in disability and even dementia.
Therapy
Stiffness and lack of movement can often be reduced by using certain medicines. Dopamine-like substances (Sinemet, Madopar) or substances that stimulate the release of dopamine are often used. Annoying side effects of these anti-Parkinson’s drugs can include:
- A dry mouth
- Constipation
- Accommodation disorders of the lens
- Urinary retention
- Palpitations
In addition to medication, continuous active exercise therapy is very important, which can significantly improve motor performance. If the patient is distracted (counting), this can have a beneficial effect on his movement pattern. For this reason and also to prevent isolation, it is preferable to practice in groups. Speech and writing therapy can be part of this. Because the image is so strongly influenced by negative emotions, patience, understanding and loving treatment are more decisive than elsewhere in reducing physical and psychological inhibition. Body care deserves special attention due to the increased secretion by sebum, sweat and salivary glands.
