Parkinson’s disease

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CME

What is Parkinson’s disease
Parkinson’s disease is a progressive disease of the nervous system that is mainly characterized by movement disorders.

Symptoms increase slowly, sometimes with a barely noticeable tremor in one hand. Tremor is the key symptom, but often the disease leads to stiffness and slowed movements.

It should be noted that Parkinson’s disease leads not only to motor disorders, but also disorders in the cognitive, autonomic, and sensory areas.

Causes of Parkinson’s disease
In Parkinson’s disease, the nerve structures responsible for synthesizing the chemical mediator dopamine are destroyed. When the level of dopamine decreases, there is an increase in uncoordinated activity of the brain, which leads to impaired movement and other manifestations of the disease.

The following factors play a role in the development of Parkinson’s disease:

Hereditary factor. If there are close relatives suffering from Parkinson’s disease, the chance of developing this pathology increases;
Adverse environmental conditions. Exposure to certain toxic substances may increase the risk of developing late-onset Parkinson’s disease, but the risk is relatively low;
Age. The incidence rate increases with age;
Male gender. Men are 1.5 times more likely to develop this pathology.
Parkinson’s disease symptoms
Early symptoms of Parkinson’s disease may be mild and go unnoticed. Often, symptoms begin on one side of the body, progress later in life, and will always be more pronounced than on the other side of the body.

Motor symptoms of the disease include the following:

Tremor. Tremors usually start in the fingers, may be observed at rest;
Slowness of movements (bradykinesia). As the disease progresses, the rate of performance of habitual movements slows down. Simple tasks become difficult to perform and take a lot of time. Patients suffering from Parkinson’s disease are characterized by a semicircular gait due to a shorter stride, and the handwriting changes.
Rigidity of the musculature. Increased muscle tone can occur in any part of the body. This condition leads to painful sensations and limits the range of motion;
Loss of facial expressions, changes in speech, and decreased plasticity of motor skills;
Impairment of the ability to maintain balance.
Non-motor manifestations of the disease:
Disturbances of memory, attention, orientation
Decreased ability to work
Dementia
Depression
Anxiety
Sleep and wakefulness disorders
Gastrointestinal, cardiovascular, and excretory dysfunctions
Diagnosis of Parkinson’s disease
Parkinson’s disease is diagnosed by a neurologist primarily based on the clinical picture.

Currently, the diagnostic method with very high specificity is the comparison of the patient’s clinical picture with the Bank’s criteria. Criteria excluding PD and criteria confirming PD have been defined.

In order to make a reliable diagnosis, a pathomorphological study confirming the presence of Levi’s corpuscles in the preserved neurons is necessary.

MRI and CT scans are usually performed to rule out other causes of neural symptoms rather than to confirm the diagnosis.