The term "parkinsonism" is meant a number of diseases of the nervous system that occur with the tremor. There are primary parkinsonism. or Parkinson's disease, and secondary or symptomatic. Secondary parkinsonism may be caused by infectious, traumatic brain injuries, infections, or drug exposures, as well as vascular and neoplastic diseases.
The main clinical manifestation of Parkinson's are tremor, rigidity and stiffness, low amplitude and the "stiffness" of movements, as well as a violation of muscle reflexes. One of the first manifestations of a violation of handwriting - decreases font size and clarity of their writing. Joins gipomimiya - reducing facial expression, his face becomes masklike, sometimes with a frozen grimace of surprise or sadness. Significantly slows the movement blinking eyelids, slurred speech becomes, and monotonous. Gradually a feeling of stiffness throughout the body. Sick for a long time may be in positions not possible for healthy people, such as lying with the head elevated on a pillow (a symptom of "air cushion"). Significantly change gait.
The first steps are made with great effort, and then the patient is moving fine, festinating steps, the rate of which increases gradually, the patient, as it were "catching up" its own center of gravity. stop it as difficult as to start the movement. You experience the paradoxical motor phenomenon: for example, a patient who could hardly rise from his chair. can easily run up the stairs, or walking, stepping over large obstacles. Temporary "disinhibition" and facilitating the movement can occur under the influence of strong emotions, both positive and negative - of joy or fear.
Another important manifestation of Parkinson's disease is muscular rigidity. As the disease progresses, it gradually increases, accompanied by the development of a characteristic posture with a predominance of flexion of the limbs and trunk: neck flexed. Golovan bent forward, arms bent at the elbows and brought to the body, back hunched and legs slightly bent at the hip and knee joints. If you try to straighten the arm or leg strength the patient, there is increased resistance to the muscles, as throughout the extension and flexion. The muscles unbent and bent as if with small jerks, as the gears - the so-called symptom of "gear".
Another characteristic manifestation of Parkinson's disease is tremor of the whole body, especially noticeable in the hands and head. The frequency of tremor in different parts of the body may be different, but on average - 4-8 cycles per second. Usually more pronounced tremor at rest and decreases markedly when the targeted movements. Emotional stress and increase the emphasis is usually tremor. Beginning with the fingers, he said, as the disease progresses, spreads en other muscle groups, grasping the lower jaw, tongue and lips. the lower limbs.
In the treatment of Parkinson's disease is not universal schemes. Treatment program for each patient should be individual, however, rationally chosen treatment regimen will achieve good results for a long time. The main drugs used in treatment are the means of acting on different neural mediators - acetylcholine, dopamine. These are some of the group of antidepressants, antipsychotics, anticholinergics. Previously, surgical treatment of parkinsonism (the operation to destroy parts of the brain responsible for muscle rigidity and tremor) in the present practice does not apply. The reason is quite successful pharmacotherapy, the progress which has in recent years.
