Hands and feet tremble (tremor), movement slows down (agitation). The body becomes stiff (stiffness), and the gait is unstable (gait disorder). Many fall and get injured. It is a typical symptom of Parkinson’s disease. Parkinson’s disease is a representative disease that threatens the life of the elderly, accounting for about 85% of all patients in their 70s or older.
The number of patients with Parkinson’s disease in Korea is steadily increasing along with the increase in life expectancy. Last year, 120,547 people visited the hospital for Parkinson’s disease. That is an average of 330 people per day (Health Insurance Review and Assessment Service). Parkinson’s disease progresses slowly, and typical movement disorders are not seen in the early stages, and in many cases, smell disorders, constipation, and depressive symptoms appear first. This is also the reason why you belatedly go to the hospital after recognizing it as simple aging. It is important to take a good look at the health of your parents or the elderly around you and to get a diagnosis if you see any abnormal symptoms. Most of the earliest symptoms of Parkinson’s disease movement disorders are minute tremors.
Parkinson’s disease is caused by a lack of production of the neurotransmitter dopamine in the brain. On the other hand, in Parkinson’s syndrome, dopamine production is normal, but dopamine does not function properly due to lesions or malfunctions in the brain itself. Since both diseases are caused by a decrease in the role of dopamine, the symptoms are similar, but the prognosis and treatment are very different. Dopamine regulates muscles, is involved in body movement and equilibrium, and acts like a lubricant for machines. Therefore, if dopamine is not produced or does not function properly, the symptoms that occur when the lubricant is insufficient in the machine appear. tremor, slow motion, stiffness, and gait disturbance.
Symptoms of Parkinson’s disease improve when dopamine is administered. It responds well to drugs containing dopamine, and it is possible to live a nearly normal life. This period is called the honeymoon period, and although there are individual differences, it usually lasts for 5 to 7 years. However, Parkinson’s disease is a representative neurological degenerative disease, and even administration of dopamine preparations cannot prevent the progression of the disease. Over time, the dose of dopamine is bound to increase. At this time, the side effect that occurs as the dose of dopamine is increased is dyskinesia caused by dopamine. In addition, the body’s ability to accept dopamine gradually deteriorates, resulting in a side effect of extremely shortening the duration of the drug’s effect.
What can be considered at the time when these drug side effects appear is Deep Brain Stimulation (DBS). Deep brain stimulation is a method of inserting tiny electrodes into the brain to deliver electrical stimulation to specific areas. When the electric stimulation generator is operated after the operation, electric stimulation starts on the electrodes implanted in the brain, and the abnormal movement symptoms gradually improve. In other words, by increasing the responsiveness to the drug and reducing the dose of the drug, side effects caused by the drug treatment are alleviated and the patient responds well to the drug treatment like a honeymoon period. However, the indication must be Parkinson’s disease, not Parkinson’s syndrome, and it is possible for the elderly if there is no severe brain atrophy or other lesions, but surgery is difficult for patients with severe mental illness or dementia. In addition, symptoms other than movement disorders are not easy to improve.
Parkinson’s disease is an incurable disease that is difficult to cure. However, with the development of treatments and treatment technologies, the quality of life of patients with Parkinson’s disease has improved significantly and the quality of the remaining life has also improved. Rather than the burden of active treatment, it is necessary to find a specialist and make an effort to find the best treatment through detailed examination and sufficient consultation. [편집국]
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2023-08-22 12:57:00
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