![[건강라이프] Frequent hand tremors, early symptoms of Parkinson’s disease… Need to distinguish between trembling](https://i0.wp.com/cdn.thegolftimes.co.kr/news/photo/202211/56406_68544_426.png?fit=%2C "[건강라이프] Frequent hand tremors, early symptoms of Parkinson’s disease… Need to distinguish between trembling")
[골프타임즈] Parkinson’s disease is a neurodegenerative disease of the brain characterized by symptoms such as slow movement, tremor at rest, muscle stiffness, shuffling and hunched posture. It was first discovered in the late 19th century and occurs most often in people over the age of 60. It occurs in 1 in 1,000 people, and in Korea the risk is higher than in other breeds because they have the onset gene. Parkinson’s syndrome is one of the three major senile brain diseases along with dementia and stroke.
Parkinson’s syndrome is a term that refers to all cases of Parkinson’s symptoms. The degeneration of dopaminergic neurons is called Parkinson’s disease. Parkinson’s syndrome is a broader concept. It is broadly divided into two types, neurodegenerative and secondary, and most occur in the neurodegenerative form. This is caused by abnormal proteins building up in nerve cells and causing them to die and includes Parkinson’s disease, progressive supranuclear palsy, multiple system atrophy, cerebellar atrophy, dementia with Lewy bodies, and hypocortical hypoplasia.
The most common of these is Parkinson’s disease. Periodic testing is important as 6.2 million people are diagnosed each year and 117,000 die. In particular, the cause is not clearly identified and it is difficult to know exactly with just one test, so repeated tests are needed.
What is known so far is that an abnormal protein called alpha synuclein builds up in brain cells, but it is not clear why this phenomenon occurs.
Alpha synuclein begins to build up in the brainstem, which connects the brain and body. When this reaches the substantia nigra of the midbrain and destroys more than 50-70% of the brain cells, externally observable symptoms appear. Acute Parkinson’s disease can also occur when the substantia nigra is artificially destroyed and is typically destroyed due to drug toxicity. The substantia nigra produces dopamine, and dopamine stimulates the brain to make precise movements, compensate for a sense of accomplishment, and control movements.
This causes hand tremors, slow movement, hunched posture, and muscle stiffness. However, when alpha synuclein is only present in the lower part of the brain, it may not be accompanied by any symptoms or may appear non-motor. For example, they may have REM sleep disturbances or have difficulty smelling due to damage to the olfactory cortex. Due to REM sleep disorder, dream actions are actually performed by moving the limbs. In general, the brain stem blocks the signal and does not move, but in Parkinson’s disease patients, the brain stem is damaged and cannot be controlled , so they move while they are.
When dopamine production is reduced by less than 70%, Parkinson’s symptoms appear. At first they cannot properly perform movements that require precision, such as wands and writing, and their walking speed decreases and they do not swing their arms well when walking. Tremors may be seen when standing still, slow, tight movements may be seen, and facial muscle movement may be reduced, resulting in a lack of expression. This can sometimes be accompanied by depression. The facial muscles are not controlled, so saliva flows or the volume of the voice decreases.
It was previously thought to be a disease with movement symptoms only, but in reality various abnormalities occur in addition to movement. Depression, dementia, and hallucinations were reported in 40% of all patients, and swallowing difficulties, dysarthria, orthostatic hypotension, constipation, and hyperhidrosis due to autonomic dysfunction were also observed. Even with the most common hand tremor, symptoms are initially only on one side, such as the left or right hand, and then the range gradually widens, with symptoms occurring on the other side as well.
Therefore, it is important to differentiate Parkinson’s disease from similar diseases such as essential tremor through screening and apply treatment accordingly. Since there is no single cause or symptom, it is important to consider all three factors: brain, mind and body, and preventive management to prevent secondary diseases such as dementia. Over time it becomes more serious, so it is important to prepare even if there are no abnormalities on the outside.
Help: Joo-Hong Park, Director of Soul Oriental Medicine Clinic
Reporter Moon Jeong-ho [email protected]
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