About 10 million people around the world suffer from Parkinson's disease. Does this number seem alarming? In fact, it is a large number, as this neurological disease is considered the most common worldwide according to statistics. However, some do not know it, and some people do not realize that Parkinson's is the same as Parkinson's. This calls for the need to raise awareness about this type of disease, especially with the increasing cases of neurological diseases in recent years. So, if a member of your family has been diagnosed with Parkinson's disease or you would like to know more about this disease, continue reading the following lines on the        Dalili Medical website to learn about its nature and its most important causes, in addition to the possibility of a treatment or ways to prevent it.

What are the types of tremor?

 

Tremors can occur at rest or at work, and the following is an explanation of each of them:

Tremor or tremor at rest: The tremor goes away at rest when the person begins to move, and it often affects only the hands or fingers.

Tremor or tremor during work: Movement tremors occur during the movement of the affected body part, and movement tremors are divided into subcategories:

Kinetic tremors occur during movement of a body part, such as moving the wrist up and down.

Intent or target twitching occurs during a target movement, such as touching a finger to the nose.

Task-specific tremors occur while performing a specific activity, such as writing.

Essential tremor or benign essential tremor: This type is one of the most common types, and usually affects the hands, but it can also affect the head, voice, tongue, legs, and trunk.

Parkinson's tremor: This is a common symptom in people with Parkinson's disease. It usually affects one or both hands when they are at rest, but can affect the chin, lips, face, and legs.

Nervous tremor: Nervous tremor occurs in people who suffer from dystonia, which is a movement disorder in which muscle contractions are involuntary. The contractions cause repetitive movements and may affect any muscle in the body.

Is Parkinson's disease fatal?

 

Parkinson's disease itself is not fatal, as the condition itself does not cause death. However, some complications that arise from Parkinson's disease, including falling, can be fatal. Depression associated with Parkinson's disease and the patient's inability to lead a normal life, especially in advanced cases, may cause the patient to have suicidal thoughts.

**How ​​does Parkinson's disease develop?**

 

Parkinson's disease develops as a result of damage to the nerve cells responsible for movement, which are located in an area of ​​the brain known as the basal ganglia. These cells secrete an important chemical called dopamine.

When these cells become damaged and die, dopamine levels in the brain decrease, leading to the development of the movement disorders associated with Parkinson's disease. Scientists are still not sure what exactly causes these cells to die. The brain cells of Parkinson's patients also contain cytoplasmic aggregates known as Lewy bodies, which cause what is known as Lewy body dementia, which affects memory and thinking in addition to movement disorders.

Moreover, Parkinson's patients lose nerve endings that produce norepinephrine, which is responsible for regulating many involuntary functions such as blood pressure and heart rate.

**What are the causes of Parkinson's disease?**

 

Parkinson's disease is a slowly developing neurological disorder that affects movement. Although there is no single known cause of this disease, research suggests that a combination of genetic and environmental factors play a role. Below is a breakdown of these factors:

**Genetic factors:**

Genes play an important role in the risk of developing Parkinson's disease. Although any single gene does not cause disease, the presence of certain gene mutations can increase the likelihood of developing it. The more family members have the disease, the greater the likelihood of contracting it.

**Environmental factors:**

Exposure to certain toxic substances, such as pesticides and welding materials, can increase the risk of developing Parkinson's disease. Some head injuries may also play a role, but the relationship between environmental factors and Parkinson's disease is still being studied.

**Dopamine deficiency:**

In a healthy brain, dopamine is produced in an area known as the substantia nigra. Dopamine plays a vital role in movement control. In Parkinson's disease patients, nerve cells that produce dopamine die, leading to a deficiency of this biochemical. This deficiency is thought to be the main cause of Parkinson's disease symptoms.

What are the symptoms of Parkinson's disease?

 

Patients may find it difficult to recognize the early signs of Parkinson's disease, which can begin several years before motor symptoms appear. These signs include:

- Decreased ability to smell (anosmia).
- Constipation.
- Difficulty in writing, as handwriting becomes smaller and letters stick together.
- Voice changes.
- Spinal curvature.

**Basic motor symptoms of Parkinson's disease:**

 

- Tremor or shaking of the body while resting, often starting in one arm or hand.
- Slowed movement, which may lead to periods of immobility (difficulty initiating movement).
- Stiffness in the arms, legs, and torso, which may limit movement and be painful.
- Balance problems and increased tendency to fall.

**Secondary symptoms of Parkinson's disease:**

 

- Fixed facial expressions (change slightly or not).
- Stumbling while walking.
- Loss of muscle control.
- Muffled speech and low volume.
- Weak ability to blink.
- Difficulty swallowing, which increases the risk of problems such as pneumonia or choking.
- Tendency to fall backwards.
- Inability to move the armsNaa walking.
- Intermittent steps while walking.
Other symptoms associated with Parkinson's include:

- Seborrheic dermatitis, which is characterized by the presence of white or yellow scales on oily areas of the skin.
- Sleep disorders, such as speech and movement during sleep.
- Depression.
- Anxiety.
- Hallucinations.
- Psychosis.
- Fatigue.
- Sexual weakness.
- Drooling.
- Low blood pressure, which may lead to dizziness.
- Problems with attention and memory.
- Difficulty in eye contact.
- Loss of control over urination (urinary incontinence).

**Stages of Parkinson's disease**

 

Parkinson's disease, known as Parkinson's disease, is a disorder that develops gradually through multiple stages. Doctors divide the stages of the disease to facilitate the assessment of symptoms and guide treatment effectively.

Symptoms of movement disorders begin on one side of the body and then move to the other side over several years. As symptoms worsen, the patient experiences difficulties moving, walking, and speaking, in addition to performing usual daily activities.

Symptoms develop slowly, and the rate of disease progression varies from person to person, depending on multiple factors.

**Here's an overview of the main stages of Parkinson's disease progression:**

**The first stage: the beginning**

Symptoms appear mild, as the tremor is usually in one hand, with slow movement and muscle rigidity appearing on one side of the body. These symptoms may be mild and not noticeable to others. Its effect is limited, as it does not significantly affect the ability to carry out daily activities.

**The second stage: early development**

Symptoms increase, as tremor increases, movement becomes more difficult, and muscle rigidity appears more clearly. Symptoms may appear on both sides of the body or axially without affecting balance. This stage usually appears after several months or years. The patient may have greater difficulties with daily activities, such as writing or getting out of a chair.

**The third stage: intermediate development**

Symptoms escalate, with loss of balance, slowness of movement and muscle stiffness, which greatly affects daily life. The chances of losing balance and falling increase, which increases the risk of injuries.

**The fourth stage: advanced development**

Significant mobility impairment occurs, as the patient loses the ability to carry out daily activities without assistance, even though he can walk and stand on his own. Slowness in movement is very noticeable, and problems with writing and muscle control may occur. The disease also affects the ability to move around independently, which may require mobility support.

**The fifth stage: the advanced stage**

 

**Care Dependence:** At this stage, the Parkinson's patient loses the ability to walk, making him dependent on a bed or wheelchair. The patient needs full support in movement and daily activities, and may have problems controlling urine and stool.

**Comprehensive effect:** The effect of the disease extends to all aspects of daily life, and may affect vital functions such as swallowing and temperature regulation.

Regardless of the stage, Parkinson's disease requires comprehensive management and medical support to improve the patient's quality of life and reduce the impact of the disease on his life and the life of his family.

**The final stages of Parkinson's disease**

 

Parkinson's disease is a condition that develops gradually over time, and the progression of the disease varies from person to person. In advanced stages, difficulties with movement increase and daily activities become more challenging.

The final stages of Parkinson's disease can be summarized in the following points:

1. **Increasing movement difficulties:** As the disease progresses, muscle stiffness and joint stiffness increase, making movement more difficult. A person with Parkinson's may find it difficult to move and walk, and may need help to perform daily activities.
**2. Worsening of shaking and loss of control of movement:**

Tremor is a major symptom of Parkinson's disease, and it may get worse in the final stage, making it difficult to control. This aggravation may complicate the performance of simple movements and daily activities.

**3. Poor ability to control the body:**

In advanced stages of the disease, loss of control of movement can cause general impairment of body control. A person with Parkinson's disease may need extra help to perform daily activities, making mobility difficult.

**4. Balance problems and falls:**

Increased movement difficulties and loss of body control lead to balance problems. The patient may have difficulties standing and walking, which increases the risk of falling.

**5. Problems speaking and swallowing:**

In advanced stages, the ability to articulate and speak clearly may be affected. The patient may also have difficulties swallowing, leading to additional feeding problems.

**6. Worsening of emotional and mental problems:**

Emotional and mental problems, such as depression and anxiety, may worsen, adding to the challenges a person with Parkinson's disease faces.

In this final stage, the impact on daily life is significant, and the person often needs full support and ongoing care. Although symptoms can be alleviated through drug treatments and physical therapy, the disease remains a difficult challenge.
What are the complications of Parkinson's disease?

 

Over time, if the patient cannot control symptoms, complications of Parkinson's disease may include:

**Mood and behavioral changes:** Having a chronic condition such as Parkinson's can lead to significant changes in feelings and mental state. Therefore, Parkinson's patients often experience periods of depression as they try to improve their condition and physical symptoms.

**Sleep problems:** As a result of physical and emotional disturbances, Parkinson's patients often suffer from abnormal sleep patterns. Some may wake up frequently during the night, while others find that their biological clock changes, causing them to wake up earlier than usual orTo sleep for long periods during the day.

**Fatigue and lethargy:** Due to the physical, emotional, and mental exhaustion associated with Parkinson's disease, a person quickly loses energy and feels tired for long periods of time even without exerting effort.

**Thinking difficulties:** The ability to think clearly and respond appropriately may be affected in people with Parkinson's disease, especially in the advanced stages of the disease.

In addition, a Parkinson's patient may experience other physical difficulties, such as:

- Difficulty swallowing comfortably.
- Drooling (as a result of increased accumulation of saliva in the mouth due to the patient’s inability to swallow it).
- Difficulty controlling urination or problems urinating.
- Chronic constipation (due to slow movement of the digestive system).
- A sudden drop in blood pressure, causing dizziness.
- Difficulty recognizing smells.

**How ​​to prevent Parkinson's disease**

 

Parkinson's disease appears genetically or unexpectedly, neither of which can be prevented. However, many studies indicate that the risk of contracting the disease can be reduced through some preventive measures, including:

1. **Avoid Toxins**: Individuals should take precautions when handling toxic chemicals, such as herbicides, pesticides, and solvents. It is best to wear protective clothing to reduce exposure to these materials as much as possible.

2. **Avoid head injuries**: To protect against brain injuries, protective helmets should be worn while playing contact sports, as well as when riding bicycles or motorcycles. It is important to use a seat belt and consult a doctor if any head injuries occur to avoid future risks.

3. **Exercise**: Regular physical exercise helps reduce the chances of developing Parkinson’s disease, as it contributes to maintaining dopamine levels in the brain.

4. **Follow a diet rich in antioxidants**: Some dietary choices can contribute to reducing the risk of Parkinson’s disease and other diseases. Research has shown that turmeric, berries, apples, green tea, and red grapes contain antioxidants that may help reduce risk by preventing oxidative stress.

5. **Avoid aldehydes**: Heating and reusing some cooking oils, such as sunflower oil, may form aldehydes, toxic chemicals linked to Parkinson's and other diseases. Studies have shown that potatoes fried in previously used oils may contain high levels of aldehydes.

**Methods of treating Parkinson's disease**

 

**Surgery**:

In some advanced cases, surgery may be an option to treat Parkinson's disease. The doctor discusses with the patient the benefits and risks of each type of surgery to ensure its suitability. It is important to note that surgery may help relieve symptoms, but it does not cure the disease or stop its progression. There are three main types of surgery that can be performed:

1. **Lesionectomy**:
 In this procedure, deep areas of the brain are targeted and small lesions are created in the parts responsible for controlling movement. Surgery may be performed while the patient is awake to determine the exact location of the lesion, which helps control or stop excessive brain activity that causes tremors.

2. **Deep Brain Stimulation (DBS)**:
 In this type of surgery, a small electrode is implanted in vital areas of the brain responsible for movement. The electrode is connected to a small battery in the chest wall via wires under the skin, and the stimulator is turned on to disrupt the brain's normal flow of information, which helps reduce symptoms.

3. **Cauterizing the nucleus of the thalamus (Thalamotomy)**:
 This procedure targets a specific nucleus within the thalamus, an area deep in the brain that plays an important role in transmitting sensory and motor signals. Surgery aims to disrupt abnormal activity in this nucleus, which helps control symptoms such as tremor.

Surgery may be performed while the patient is awake to ensure accurate targeting. A fine probe is inserted through a small opening in the skull into the nucleus of the thalamus, where heat energy or radio waves are used to destroy a small part of this nucleus, which contributes to reducing symptoms.

**Physiotherapy**:

Physical therapy can help improve movement, balance, and coordination. Physical therapists provide specific exercises to strengthen muscles and increase flexibility and endurance. Your doctor may refer you to a physical therapist tailored to your needs.

**Occupational therapy:**

Occupational therapy can help make it easier to perform daily tasks that may become difficult as a result of Parkinson's disease. Occupational therapists provide suggestions for modifying the home or workplace environment, as well as teach assistive techniques to make tasks easier. Your doctor may recommend that you be referred to an occupational therapist for these services.

**Treatment of Parkinson's paralysis with medications:**

 

Medications used to treat Parkinson's aim to increase the low level of dopamine in the brain in Parkinson's patients, which helps relieve tremor and other motor symptoms. These medications include:

- **Levodopa:** Levodopa is considered the most common drug for treating Parkinson's disease, as it works to raise the level of dopamine in the brain, and is often used with Carbidopa.

- **Dopamine agonists:** These medications mimic the effect of dopamine in the brain, and examples include Pramipexole and Ropinirole.

- **Anticholinergics:** These medications are used to reduce the symptoms of tremor and muscle stiffness, including Benztropine.

- **Catechol-O-methyltransferase inhibitors:** These medications are used to prolong the effect of levodopa by inhibiting the enzyme responsible for breaking it down in the body. Examples of them are Tolcapone and Entacapone.

- **Monoamine oxidase B inhibitors:** These medications work by inhibiting the enzyme monoamine oxidase B, which breaks down dopamine in the brain.Selegiline and rasagiline.

- **Amantadine:** Amantadine is used to relieve motor symptoms in patients with Parkinson's disease.

**Treatment of Parkinson's palsy with alternative medicine:**

 

There are many alternative treatment options that may contribute to the treatment of Parkinson's disease, but it is necessary to consult a doctor before using any of them, and not to rely on them as a substitute for prescribed medications.

Alternative treatments for Parkinson's disease include:

- Acupuncture.
- Practicing yoga.
- Hypnosis.
- Biofeedback.
- Aromatherapy.
- Massage.
**Treatment of secondary symptoms of Parkinson's disease**

 

Treatment for Parkinson's includes strategies that may help alleviate secondary symptoms of the disease, such as:

- **Constipation**: It is recommended to eat foods rich in fiber, drink sufficient amounts of water and fluids, in addition to exercising regularly.

- **Positional hypotension**: Drinking fluids and eating salty foods can help reduce the feeling of dizziness associated with this condition.

- **Depression and anxiety**: Exercising or undergoing psychological or drug treatment may contribute to alleviating the severity of depression.

- **Insomnia**: Adjusting your nightly routine can help improve sleep quality.

**Sexual problems**: It is preferable to consult a doctor to determine the appropriate treatment according to the condition.

- **Hyperhidrosis**: Antiperspirants can be used to reduce the amount of sweat, and in severe cases surgery may be an option.

**Difficulty swallowing**: It is recommended to choose soft-textured foods to avoid the risk of choking, and to consult a doctor to prescribe appropriate treatment, as severe cases may require the use of feeding tubes.

- **Urinary incontinence**: Pelvic floor muscle strengthening exercises can help relieve urinary incontinence. The doctor may prescribe some medications, while severe cases may require surgery.