What is Parkinson's Disease ? What Causes Parkinson's Disease ? Treatment of Parkinson's Disease

Updated: Nov 8


What is Parkinson's Disease ?


Parkinson's disease occurs as a result of the deterioration of cells in the brain that produce a substance called dopamine, which allows brain cells to communicate with each other. Cells that produce dopamine in the brain are responsible for the control, harmony and fluency of movements.


The disease, which manifests itself with slowness in movements, tremors at rest, and psychiatric disorders, is mostly seen in people after the age of 60. However, due to genetic reasons, it can also be encountered in the 40s. The first choice in treatment is drugs. However, in some people, when the drug treatment is insufficient or if intense side effects develop, the "brain pacemaker" method may be preferred.


Contents

1.What is Parkinson's Disease ?

2.What Causes Parkinson's Disease ?

3.What Are the Symptoms of Parkinson's Disease ?

4.What is a Brain Battery ? How is a Brain Battery Applied ?

5.Diagnosis of Parkinson's Disease

6.Treatment of Parkinson's Disease


Atypical Parkinson's or Parkinson's plus diseases can mimic Parkinson's disease in the early stages. In order to call it classic Parkinson's, in addition to the main findings, the patient's response to Levodopa should be good, even for a short period of time.

When atypical Parkinson's disease is mentioned, we can count the diseases we call multiple system atrophy, progressive supranuclear palsy and corticobasal degeneration. Secondary parkinsonism occurs as a result of different causes that can be defined as nondegenerative; These may be drug use, exposure to toxins, fluid retention in the brain, or a brain tumor.


What is Parkinson's Disease ? What Causes Parkinson's Disease ? Treatment of Parkinson's Disease

What Causes Parkinson's Disease ?


Parkinson's disease is caused by the loss of cells in the dopamine-producing region of the brain, resulting in under-release of this substance. Although some chemicals such as pesticides can cause this cell loss, genetic factors can also cause it.


What Are the Symptoms of Parkinson's Disease ?


Parkinson's disease is caused by the loss of cells in the dopamine-producing region of the brain stem, resulting in under-release of this substance. In addition to these findings, which are related to the movements of the patients, they may also have many different complaints. Such as fatigue, decreased cognitive functions,

depression, anxiety, behavioral disorders, visual impairments, weight loss, sleep abnormalities and pain.


Its classic findings are tremor, tremor, rigidity (rigidity), slowed movement (bradykinesia), and standing (postural instability). Parkinson's disease often develops gradually and its manifestations throughout the body are often asymmetrical. Gradually, the condition of the disease progresses. There is a response to dopaminergic drugs.


How Does Parkinson's Disease Affect Daily Life ?


If we consider the main findings of Parkinson's disease one by one;


-Tremor, hand tremor; Uncontrolled movement of the thumb, tremors in the chin and lip, and sometimes twitching in the leg muscles may accompany. It should not be forgotten that not all hand tremors mean Parkinson's disease.


-The tremors in Parkinson's disease occur when the hands are at rest. It is necessary to distinguish it from tremors that occur when stressed and excited, develop after coffee or drug consumption, or with a familial tremor disease called essential tremor.


-Slowing of Movements (Bradykinesia); Difficulty in starting and maintaining movement are common findings in Parkinson's Disease. Patients often walk with short steps and have body aches due to muscle stiffness.


-Changes in Speech: Increase in speech rate or speaking with a low tone of voice, decrease in facial expressions and monotony of speech are among Parkinson's findings.


-Degradation of Handwriting; Sudden worsening of handwriting, shrinkage of words or close spelling of words should suggest Parkinson's disease.


What is a Brain Battery ? How is a Brain Battery Applied ?


The patient's first brain MRI is taken. The target to which the brain battery will be placed, which is determined according to the patient's findings, is determined on the MR. On the morning of the surgery, a frame is placed on the patient's head with local anesthesia and the patient's brain tomography is taken. The coordinates of the target are arranged by combining the brain tomography and the MR image. Then the patient is taken to the operating room and the first stage of this 2-stage operation begins. Under local anesthesia, long rods (electrodes) are directed to the target according to the determined coordinates, without putting the patient to sleep. At this stage, progress is made by talking to the patient.


The accuracy of the target is confirmed by monitoring the sounds of the cells in the brain with microelectrode recording. Two electronic rods (electrodes) are permanently placed in the area where the patient's findings improve. Then the frame on the patient's head is removed. The patient is completely anesthetized and the second stage of the operation is started. The placed electronic sticks are connected under the skin with the help of an extension cable with the battery placed under the collarbone.


What Are the Risks of Brain Pace Surgery ?


Brain surgery has less risk than many surgeries performed. Brain bleeding, infection, vascular occlusion, weakness in the arms and legs, deterioration of vision, depression, etc. It can be observed in the form of 1-2%.


How Does a Brain Battery Benefit from Parkinson's Disease ?


There is improvement in side effects such as involuntary contractions (dyskinesia) due to drug intake. Severe fluctuations between drug intakes due to the decrease in the drug in the body decrease. Although it varies according to the surgical target, there is a decrease in drug doses. With the increasing independence of patients, the rate of participation in daily life increases.


In which other diseases is the brain battery used ?


-Familial tremor disorder (essential tremor),

-Contraction disease of certain parts of the body (dystonia),

-Tic disorder (Tourette syndrome),

-Obsession (Obsessive compulsive disorder),

-Depression,

-Chronic Pain,

-It is used in the field of epilepsy.

-In addition to these, studies on brain battery in the treatment of diseases such as obesity, Alzheimer's, drug addiction, and headache are continuing around the world.


How to Follow Brain Pacemaker Patients ?


After the surgery, the electrodes placed in the brain are adjusted with a remote control-like device, followed by neurologists.

Diagnosis of Parkinson's Disease

The diagnosis of Parkinson's is made by the physician after listening to the patient's complaints and the history of the disease, followed by a neurological examination. However, additional tests such as MRI, blood tests, lumbar puncture (the process of obtaining cerebrospinal fluid by entering the spinal canal with a needle from the lumbar region) can be performed in some patients who are also suspected of different diseases.


Diagnosis of Parkinson's Disease


The diagnosis of Parkinson's is made by the physician after listening to the patient's complaints and the history of the disease, followed by a neurological examination. However, additional tests such as MRI, blood tests, lumbar puncture (the process of obtaining cerebrospinal fluid by entering the spinal canal with a needle from the lumbar region) can be performed in some patients who are also suspected of different diseases.


Treatment of Parkinson's Disease


The priority in the treatment of Parkinson's is medication. With drug treatment, the production gap of dopamine in the brain is closed. Although medications can reduce existing complaints, they cannot prevent the progression of the disease. Therefore, there is currently no definitive treatment for Parkinson's. In the treatment, the treatment method is determined depending on the age of the patient, the symptoms and stage of the disease.


With drug treatment, the complaints are eliminated and the progression of the disease is slowed down. However, if the disease does not improve or if side effects related to drug use have occurred; Surgical treatments can also be used.


In surgical treatment; There are two options: brain pacing (deep brain stimulation) and brain lesion surgery (ablative methods). With the brain battery method, the effects of Parkinson's are significantly reduced and an improvement is seen in the actions that limit both the daily life and comfort of the person.


Brain Battery Method in Parkinson's Treatment


In this method, it is aimed to regulate the impaired electrical activity by placing electrodes (electronic sticks) in specific areas of the brain with full accuracy. The target area where the battery will be placed in the brain is determined before the surgery according to the patient's current complaint and additional problems.


In the surgery, under local anesthesia, a frame is placed on the head of the person and the coordinates of the target are arranged very precisely by combining the brain tomography and MR image. Electrodes in the thickness of a hair are placed on point targets called nuclei in the brain. Two permanent electrodes are placed in the brain area where the best effect is observed.


Afterwards, the frame is removed, and the patient is put to sleep and the electrodes placed in the brain are connected under the skin with an extension cable under the collarbone with the generator mechanism, just like in a pacemaker.


Parkinson's Effects Are Significantly Reduced


After the surgery, tremor, slow movement and involuntary contractions, which are side effects of the drug, decrease. People are able to meet their daily needs such as tying shoes, buttoning a shirt and drinking tea.


Some people may also have an improvement in their writing skills. People who participate in daily life are thus freed from being dependent on someone else, and their quality of life can increase.


To exercise


Prevention of the disease is not yet possible today. Early diagnosis, selection of the right treatment with appropriate drugs, physiotherapy and exercise are very important in the fight against Parkinson's disease.


Thanks to exercise, gait, balance and posture can be improved. In addition, other psychological and physiological responses of the disease such as depression, stagnation, fatigue and constipation are also positively affected.

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