PARKİNSON DİSEASE

Parkinson illness is a disease that is born slowly and insidiously and is caused by the brain's lack of dopamine. This illness begins with hand shake, muscle stiffness and slow motion which at the age of 70 can be noticed in every 100 people.

One of the substances that is produced by the brain cells and maintains the body's balance is dopamine. When these cells diminish or suffer damage they no longer produce dopamine. As soon as dopamine is not produced, are noticed shake of hands and body, slow movement of the body, muscle stiffness, etc. Based on these symptoms we can say that we are dealing with Parkinson's disease.

Although Parkinson disease is one of the most studied neurological diseases, the cause is still unclear. There are ongoing studies based on the genetic structure of affected persons, toxins, and certain brain substances.

ATTENTION!

Parkinson disease is a disease that can be seen at almost any age. Begins between the ages of 20-80 years. Parkinson disease is more seen in people over the age of 70, though rarely, it can also be seen at an early age.

Because Parkinson disease is a very slow and secretive disorder, recognizing clinical signs of illness is very important for diagnosis.

Symptoms such as muscle stiffness, back pain and soft tremour are seen during the 2-3 year period, which is considered as the initial stage of the disease. It is useful for patients living with these indications to consult a neurologist, especially if they are over 70 years of age. Over time, Parkinson disease manifests itself more clearly.

These symptoms are:

Tremour
In Parkinson disease, the first symptoms noticed are tremours. Tremours are also noticed even when the patient is resting. Sometimes the tongue can affect the jaw and lips. However, tremours are noticed mainly in the hands.

Muscular Stifness
Muscle stifness is the most common symptom.

Slowdown on Movement
At first, there are difficulties in simple activities, eg. keeping a cup, glass etc. Slowness gradually increases over time. There are difficulties in doing daily activities.

 

Symptoms such as walking disorders, persistence, difficulty swallowing, bending forward while standing, are also seen in Parkinson's patients.

DIAGNOSIS OF THE PATIENT

This disease is followed by neurologists. In the diagnosis of Parkinson disease, patient history and findings during examinations are important. It can’t be said every time that the diagnosis of tremours is Parkinson disease, so examinations at the neurologist are important. Stress, fatigue, and caffeine make worst the symptoms of tremours. It should be investigated and then definitely diagnosed if the patient has or does not have other clinical signs.

PRIORITY TREATMENT IS WITH MEDICAMENTS

There is no definitive solution to the treatment of Parkinson disease. However, the first steps of treatment are medications that are applied to slow the progression of the disease. Parkinson disease lasts on average 25 years. At this point, early treatment with medications is important. Drug therapy begins with a specific dose. Over time, the dose increases.

DEEP BRAIN STIMULATION (DBS) TREATMENT

Deep Brain Stimulation (DBS) is a surgical procedure used to treat a variety of symptoms of neurological disorders - most of the symptoms of Parkinson disease (PD), such as tremours, stiffness, slow motion and walking problems . The procedure is also used to treat essential tremours, a neurological disorder that affects the motion. Deep brain stimulation does not hurt healthy brain tissue by destroying nerve cells. The procedure blocks electrical signals coming from targeted areas in the brain. For the time being, the procedure is only used for patients whose symptoms can not be controlled and treated with medications.

DBS uses a battery-operated medical device that is implanted by surgery and called a neurostimulator-similar to a heart stimulator which has approximately the size of a chronometer-to transmit electrical stimulation to targeted areas of the brain, which control movements, blocks neural signals that are not normal and cause temours and other symptoms similar to Parkinson disease. Before the operation, a neurosurgeon uses magnetic resonance imaging (MRI) or CT scanning to identify and locate the target brain area where nerve signals cause vibration and other symptoms such as those of Parkinson disease.

Some surgeons may use microelectrode recordings that include a thin filament that monitors nerve cell activity in the targeted area-to more specifically identify the area of the brain that should be stimulated. Generally, these targeted areas are thalamus, central subtalamus, and a part of the globus pallidus. As soon as the system is installed, the electrical impulses are sent from the neurostimulator, above, through the thin wire extension, in the right direction to the brain. These impulses interfere with electrical signals that cause vibrations and block these signals.

The whole procedure lasts on average about 3-4 hours.

 

The deep DBS brain stimulation system consists of 3 components:

The head (also known as electrode) - a thin and isolated wire - is inserted through a small opening in the head and implanted in the brain. The electrode bore is positioned in the target brain area.

The elongation is an isolated wire that passes under the skin of the head, neck and shoulders, connecting the head with the neurostimulator.

Neurostimulator- is the third component and is usually implanted under the skin, close to the clavicle. In some cases it can be implanted below, in the chest or below the skin on the abdomen.

The patient stays in intensive care one night. After 3 days the patient leaves the hospital and comes for a check up after 7-10 days.

Significant improvement have been achieved in the quality of life wih deep brain stimulation for patients diagnosed with cerebral palsy.