Parkinsonism. Symptoms, treatment

Clinical presentation includes a triad of symptoms: akinesia, rigidity and tremor of the muscles.Was accompanied by gait disturbance, autonomic dysfunction, and pain.Idiopathic form of the disease usually occurs after age 50 and begins with either shake hands or with partial or total restraint.Gradually, tremor and akinesia generalizes appears stiff muscles, with a gradual increase in tone in the limb during repeated pa*sive movements and tolchkooobraznoy hypertension (cogwheel phenomenon).Changing posture and gait: the patient more stooping, walking with tiny steps, disappear friendly hand movements during walking (aheyrokinez).Oskudevaet mimicry of patients; slowed flashing, his face becomes maskoobraznym.Characterized by the paradoxical kinesis: the patient is not able to walk independently, easily runs up the stairs, can dance, skiing.Some patients have propulsion: the slow movement gives way to sudden rapid run, which the patient can not overcome until the fall or do not meet an obstacle.Observed universality of facial skin, hypersalivation.Often disturbed urination.To a certain extent oskudevaet and emotional life of patients gradually developed dementia.Normal muscle strength, reflex and sensory area does not suffer.The disease usually progresses, but the rate of growth of motor disorders is very different.In severe cases or in late stage disease the patient is almost completely immobilized and can not get out of bed, even with a*sistance.The differential diagnosis of senile tremor based on the absence of the last muscle rigidity.Essential tremor occurs at a younger age.Tremor in thyrotoxicosis and brain fever combined with the characteristic signs of these diseases.Pyramidal spasticity as expressed in the early pa*sive movement (symptom jackknife).Treatment of parkinsonism in the treatment of Parkinson's universal schemes do not.Treatment program for each patient must be individually, however, rationally selected 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 groups of antidepressants, antipsychotics, holinolitikov.Previously applied surgical treatment of Parkinson's disease (surgery to destroy parts of the brain responsible for muscle rigidity and tremor), this is practically not used.The reason is quite successful pharmacotherapy, the progress which has in recent years.

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