Ways of diagnosing Parkinson’s disease

Parkinson’s disease is the name of a slowly developing pathology of the central nervous system. The main symptoms of the disease include motor disorders, muscle stiffness (increased tone), tremor at rest. Carriers of the pathology experience not only vegetative, but also affective disorders. Neurologists diagnose true parkinsonism – Parkinson’s disease – and parkinsonism syndrome in patients. The latter becomes a complication of other neurological diseases: brain malignancies, strokes, encephalitis, etc.

Parkinson’s disease diagnoses

For the diagnosis of Parkinson’s disease are used in several ways:

  • Visual examination.
  • Functional diagnostics: the method of clinico – accelerometric differential diagnostics of tremor (tremor), ultrasonic transcranial sonography (TX), tomography.
  • Laboratory tests (blood, urine).

A number of these methods of diagnostics are basic, priority, a number – auxiliary specifying.

Primarily, a patient with Parkinson’s disease suspicion is shown visual examination by a neurologist, laboratory tests, clinico-accelerometric differential diagnostics of tremor and ultrasonic transcranial sonography.

Visual examination

Ways of diagnosing Parkinson's disease

During the visual examination, the character of the shaking fingers is necessarily studied. If this is really Parkinson’s disease, then most often triggered by the rule of “rolling pills”: the patient feels that the fingers are not just shaking, and between them rolls a certain object like a pill. In addition, the tremor is asymmetrical. It is more pronounced on one hand and less pronounced on the other. Very often at the initial stage by the nature of tremor can be determined: it is necessary to continue to diagnose Parkinson’s disease, or the patient – Wilson-Konovalov disease, accompanied by a metabolic disorder. A detailed gait analysis is also performed. The doctor asks the patient to walk around the office and observe the speed. In the risk group – patients who have a clear acceleration when moving forward. Thus, patients unwittingly try to compensate for the difficulties in maintaining balance.

Functional diagnostics

Ways of diagnosing Parkinson's disease

The most effective are ultrasonic transcranial sonography and clinical-accelerometric differential diagnostics. They help not only to confirm or deny the presence of the disease, but also to choose the right treatment, including the dosage. Ultrasonic transcranial sonography helps to determine what area of the nerve cells of the brain is affected and even the predisposition to Parkinson’s disease, and accelerometric differential diagnosis is informative for the analysis of the dynamics of tremor. Tomography in the diagnosis is auxiliary. It is shown not to reveal the nature of Parkinson’s disease, but to distinguish it from other pathologies and (or) to detect neoplasms and degenerative pathologies in the patient.

Electroencephalography, Doppler, ultrasound examination of brachycephalous arteries may also be prescribed according to indications. The data obtained from these examinations are also clarifying.

Reasons for Parkinson’s disease

Parkinson’s disease (fluttering paralysis) – degenerative neurological pathology.

The nature of the disease is associated with several factors:

  • Malfunctions within nerve cells: for example, due to injury or complications after infectious diseases of the brain.
  • Disorders in the body against the background of interaction with harmful chemicals.
  • Mutations in genes.
  • With the accumulation of special presynaptic proteins in nerve cells – alpha-sinucleins.

Alpha-sinuclein proteins is produced by the nervous system itself. With a large accumulation, they become toxic and poison the brain. Human nerve cells begin to die, and the production of such an extremely important hormone as dopamine is significantly impaired. But it depends on the dopamine whether the person is able to learn, whether he can easily remember information and even hold a pen or pencil. The quality of sleep, the ability to concentrate, and the coordination of movements all depend on the same hormone. If dopamine in the body becomes scarce, the processes associated with thinking and motor activity are significantly slowed down.

Reasons for Parkinson's disease

Nowadays Parkinson’s disease is diagnosed more often than 50 years ago. But this is not due to the fact that the disease is progressing, but to the fact that people are more likely to get it after 50-60 years, and even more often 70-80 years. As life expectancy has increased over the last half a century, the number of people diagnosed with this disease has also increased. At present, about 1% of the world population suffers from Parkinson’s disease. But the disease of the elderly can not be called a pathology. People under the age of 50 may also suffer from Parkinson’s disease. As a percentage – the number of people sick is many times less, but people in the 20-40 years may also suffer from this disease. Also it is impossible to assert that Parkinson’s disease is a professional disease of people of certain professions. But the practice shows: there are areas in which you can often meet people with Parkinson’s disease. These are mining in mines and work with pesticides, agrochemicals.

Reasons

Reasons for Parkinson's disease

The most common cause of the pathology is heredity. Cell death is associated with the activation of apotosis, a mechanism that is programmed genetically. 20% of patients with Parkinson’s disease have or had relatives who are familiar with this disease. In the risk group – persons with changes in one of the genes (PARK2 gene). The essential problem is that the disease transmission through the genes is autosomal recessive, which means that it usually manifests not directly from parents to children, but through a generation or even several generations. And many people are not aware of the danger, but if there was a person who suffered from this disease, there should be regular examinations of the organism in the neurological “slice”: especially after 50 years.

But besides the hereditary factor, there are other provocateurs of the disease:

  • Taking a number of medicines. Practice shows that the disease may be caused by antidepressants of neuroleptics (methoklopramid), reserve, calcium antagonists (diltiazem), and lithium preparations. That is why these drugs are prescription ones and their administration requires strict control by a doctor. However, if the drugs were really dangerous, of course, no one would prescribe them. Everything is very individual.
  • All kinds of injuries (especially dangerous concussions).
  • Encephalitis – no matter what nature they have – viral or bacterial. In both cases there is a high risk of damage to the structure of vegetative ganglia – clusters of multipolar nerve cells.
  • Other diseases. The provocateurs may be malignant formations, endocrine pathologies, atherosclerosis.

Parkinson’s disease symptoms

Parkinson’s disease (fluttering paralysis) – degenerative neurological pathology. Nowadays Parkinson’s disease is diagnosed more often than 50 years ago. But this is due not to the fact that the disease is progressing, but to the fact that people are more likely to get it after 50-60 years, and even more often 70-80 years. As life expectancy has increased over the last half a century, the number of people diagnosed with this disease has also increased. At present, about 1% of the world population suffers from Parkinson’s disease.

Symptoms

Parkinson's disease symptoms

Parkinson’s disease can begin with a variety of symptoms. At the same time, symptoms may be associated with disorders of motor, intellectual activity, and functions that, at first glance, are not related to the nervous system, but relate to the digestive tract and even the nose. What symptoms most often worry Parkinson’s disease sufferers?

  • Tremor at rest (in a calm state – sitting, lying down, a person starts to shiver, the shiver goes away). Especially often, the problem starts with the tremor of the hands and the head.
  • Leg stiffness. A person can’t walk quickly – but not because he has shortness of breath (as it happens with diseases of the cardiovascular and respiratory systems), it is difficult for him to control the work of his muscles. In this case, you can often hear “legs do not obey”.
  • Problems with keeping the balance.
  • Violations of blood circulation.
  • Chronic constipation.
  • Violations of the so-called fast sleep phase: at the moment of falling asleep, a person behaves not just restlessly, but actively – up to the point that causes self-injuries. However, after waking up, a person can not remember about it.
  • Loss of sense of smell.

But despite the general symptoms, the development of the disease in young and old, men and women have some differences. And the differences concern both the progression of the disease, and the very first symptoms. Let us consider these differences in detail.

Symptoms of the disease in young men and women

If Parkinson’s disease began to develop at the age of 20-40 years, its progression (in the absence of treatment) – very rapid.
The disease begins in young people, as a rule, with muscle problems. The first signs of pathology in young people are most often involuntary muscle contractions in the shoulders and feet. At first, they can be described simply as unpleasant, and then – as very painful feelings. And sometimes, the patient does not understand that it is the muscles that contract: it seems to him that the joints hurt. He begins to use ointments for arthritis, but the result is not just no, it is the opposite of what he wants: the pain increases. That is why, if there are such signs, it is important to see a doctor immediately.

Symptoms of disease in the elderly

Parkinson's disease symptoms

In older people, the disease at the beginning of the disease is slower. If the disease develops after 60 years, sometimes 10 years pass from the first symptoms to the diagnosis. And this is a great danger. After all, the earlier to identify the disease and begin treatment, the higher the chances that it will be possible to take measures that will prevent a person from losing capacity. Most often, the disease in old age begins with changes in the gait. A person begins to accelerate and at the same time shorten the steps. Often, this gait is called a seed gait. Another feature of Parkinson’s disease in older people is the “disguise” of the disease under other diseases: for example, pathologies of the cardiovascular system. But there are differences. For example, if we are talking about problems with blood pressure, Parkinson’s disease sufferers fall more often only when a person stands, walks, and in a state of rest the pressure stabilizes.

Symptoms of the disease in women

Women more often than men already at the initial stage of the disease show the following signs: neck muscles tension, which at first is difficult (without special examination) to distinguish from the signs of osteochondrosis and periarthritis; decreased intelligence; strong emotional depression; suicidal thoughts (especially in menopause); expressive painful manifestations, starting from the shoulder and neck area, etc., etc.

Symptoms of disease in men

Many men have Parkinson’s disease from the beginning accompanied by problems with potency. This is due to the fact that an erection is in the direct control of the autonomic system, one of the parts of the nervous system. One more characteristic feature is the difficulty of controlling the hands while walking. If a healthy person, while walking, instinctively flexes his hands in his elbows, often waving his hands (which is important for effective movement and energy conservation), then in case of Parkinson’s disease, a lot of effort is required to perform these actions. As in women, men suffering from Parkinson’s disease have a worse emotional background. But instead of oppression, men become overly aggressive and angry.

Dr. Denis Slinkin

Parkinson’s disease

Parkinson’s disease (also parkinsonism, fluttering paralysis) is a neurodegenerative disease characterized by shivering limbs and head (tremor), slow motion and impoverished mimics (hypokinesia), general stiffness of the body (rigidity).

According to extant sources, Parkinson’s disease was known in ancient times. The full scientific description was first provided by the English physician James Parkinson in 1817, whose name was given to the disease, according to Dr. Denis Slinkin.

Dr. Denis Slinkin claims that shaking first appears on the right side of the body and gradually switches to the left side. Tremor in Parkinson’s disease is quite specific: finger movements resemble “rolling balls” or “coin count”.

Dr. Denis Slinkin

It is especially noticeable when the patient is awake, and can disappear in his sleep. As Parkinson’s disease progresses, people suffering from Parkinson’s disease acquire a specific ‘petitioner’ pose: the head is bent down, the arms are bent in the elbows and away from the body, the legs are bent in the knees, and the torso is tilted slightly forward. The patients are characterized by a shuffling gait, perhaps a long stomping in place before moving forward.

Parkinsonism develops due to mass neuronal death in “black matter”, which is in the middle brain. 

These cells produce the neurotransmitter dopamine, which is vital for intercellular communication. Lack of dopamine causes an imbalance between different brain systems. 

According to the data available to date, in 20% of cases Parkinson’s disease is due to genetic predisposition, the remaining 80% is due to environmental factors. Parkinsonism can be triggered by neurotoxins used in agriculture, heavy metals (manganese, lead, iron) or gases (carbon monoxide), says Dr. Denis Slinkin.