Treatment of Parkinson's disease - new methods vs "shaking palsy"

Albina Golovina
Works in the field of medical copywriting for 2 years. She is a postgraduate student at the Faculty of Psychology. Author of several scientific publications in the field of clinical psychology. Additionally he studies the physiology of the central nervous system, neuropsychology and psychiatry. In her spare time, she studies mindfulness practices and conducts psychological consultations.

What unites the artist Salvador Dali, actor Michael J. Fox, boxer Muhammad Ali, musician Ozzy Osbourne and Pope John Paul II? Medical diagnosis. All of them, along with another 10 million people around the world, suffer from Parkinson's disease. Read briefly about the disease and in detail about its complex treatment - read right now in the new MediGlobus material.

Trembling as an important clinical symptom

Parkinson's disease can be characterized by various forms. Experts identify the following variants of the disease:

• akinetic-rigid form;
• trembling;
• mixed.

Parkinson's without tremor is possible, when hypokinesia (decreased motor activity) and rigidity (increased muscle tone and tension) become manifestations of the pathological condition. This form has the most unfavorable prognosis, since despite the absence of vibration, the patient develops immobility and decreased mental abilities.

Trembling and mixed forms are characterized by trembling of the upper and lower extremities, lower jaw, head, and vocal cords. Parkinson's disease characterizes hand tremors as a manifestation of a tremulous or akinetic-rigid form. As the disease progresses, the shaking also increases, making purposeful movements even more difficult. In the final stages of the disease, the rigidity and tremors of the hands in Parkinson's make self-care and movement impossible.

Treatment of Parkinson's syndrome with high doses of vitamin D

Everyone knows, and we have already discussed above, that Parkinson’s disease cannot be completely cured. But it can and should be treated, i.e. maintain the patient’s normal condition throughout his life. Such a method exists. And no matter how simple it may sound, the treatment consists of taking vitamin D. Yes, yes, that’s right, just vitamin D. But in fact, not only vitamin D.

There is such a wonderful doctor in Brazil - Cicero Galli Coimbra. This is a scientist, neurologist, professor. It was he who, many years ago, developed a method for treating autoimmune diseases with high doses of vitamin D, which is called the “Coimbra Protocol”. Parkinson's disease is an autoimmune disease that is also treatable. The essence of the protocol is taking high doses of vitamin D (from 30,000 IU) per day. In addition to vitamin D, the doctor prescribes a number of supplements after examining the test results. The patient must follow a diet (no dairy products), as well as plenty of hydration (at least 2.5 liters of fluid per day).

Attention!!! Self-medication is not allowed!!! All treatment should ONLY be carried out under the guidance of a doctor who has been officially trained by a professor in Brazil and has received a certificate.

Types of tremor in Parkinson's

The disease is characterized by the following types of tremors:

1. Rest tremor with a frequency of 3 to 6 Hertz in combination with tremor during movement of the same frequency.
2. Rest tremor combined with movement tremor of a higher frequency (6 to 9 Hertz).
3. Isolated trembling of the limbs at rest;
4. Isolated postural movement tremor.

The combination of trembling with slowness of movements and increased muscle tone constitutes the characteristic clinical picture of Parkinson's disease. The absence of difficulties with the plasticity of movements and muscle tension makes it necessary to conduct additional research methods using specific markers and neuroimaging. Essential tremor and Parkinson's disease in the tremulous form require differential diagnosis, since these diseases have a similar clinical picture.

Medicines for later stages of the disease

It is rare that a single drug is used to treat Parkinson's disease. Usually, specialists combine several medications with each other. Let's consider effective antiparkinsonian drugs.

By the way! Some antiparkinsonian drugs are expensive, but this does not always indicate their quality and effectiveness.

Amantadine

The drug effectively combats movement disorders, in particular tremor. Amantadine should not be stopped abruptly; this may cause unwanted side effects. The tablets are not compatible with alcoholic drinks.

Amantadine is contraindicated in the following cases:

• epileptic seizures;
• glaucoma (increased intraocular pressure);
• thyrotoxicosis;
• stomach ulcer;
• pregnancy period;
• kidney and liver diseases.

During treatment with Amantadine, hallucinations and attention delays may appear. Patients often complain of dry mouth, nausea, and blurred vision.

Tremor in other brain diseases

Trembling of the limbs, head, tongue, and eyelids of the lower jaw can occur not only with Parkinson's disease, but also with other diseases of the nervous system. Overdiagnosis of Parkinson's is associated with the identification of tremors as the main characteristic of this pathology. Trembling as part of the clinical picture can occur in the following pathological conditions:

• essential tremor;
• Parkinsonism syndrome against the background of the development of encephalopathy (traumatic, toxic, atherosclerotic) or Economo's encephalitis;
• pathological processes in the cerebellum (tumors or circulatory disorders in the form of a stroke);
• functional disorders of the nervous system such as neurotic conditions;
• alcohol dependence with damage to the nervous system.

Important! The greatest difficulties for diagnosis are essential tremor and Parkinson's disease, since these conditions are often not distinguished during a clinical examination of the patient.

Progressive forms of Parkinson's disease in most cases are characterized by a decrease in tremor, despite the fact that degeneration covers large areas of the subcortical structures of the brain.

Features of diagnosing parkinsonian syndrome

With parkinsonian syndrome, it is always possible to establish a connection between trembling and hypokinesia and the cause of the pathology. During the collection of anamnesis, it turns out that the patient suffered a stroke, brain injury, and encephalitis. Atherosclerosis of the brain is accompanied by changes in basic mental functions (thinking, memory, attention, emotions).

Diagnosis of tumors and strokes

Muscle vibration with cerebellar lesions is accompanied by the development of other focal neurological symptoms. The diagnosis is confirmed using neuroimaging methods (computed tomography, magnetic resonance imaging).

Diagnosis of chronic alcoholism

Alcohol addiction is accompanied by trembling of the limbs, which intensifies against the background of withdrawal symptoms. After drinking small doses of alcohol, trembling decreases.

Functional disorders of the nervous system.

Neurotic conditions and hyperfunction of the thyroid gland can cause severe trembling of the limbs. The pathological condition is accompanied by a uniform increase in tendon reflexes, emotional excitability and irritability.

Latest Treatment Methods

Medications used in the treatment of pathology, in some cases, cause the development of side effects. Today, doctors more often prescribe to patients drugs for the treatment of Parkinson's disease based on Amantadine and Levodopa with an improved formula. Among the most effective medications of the new generation are:

1. PC-Merz. This Parkinson's medicine comes in the form of a solution. Used for intravenous administration.
2. Madopar. These are capsules and tablets for Parkinson's, which reduce the severity of the clinical picture of the pathology that develops against the background of disruption of the internal organs.
3. Madopar GSS. It is used to obtain a quick effect, which is 2 times faster than the standard version of the drug.

In the absence of the effect of conservative treatment methods, patients with this pathology are prescribed neurostimulation surgery. This is a minimally invasive intervention in which electrodes are inserted into the patient’s gray matter of the brain, activating the work of nerve cells and dulling the clinical manifestations of the disease.

Distinctive features of parkinsonian tremor from other diseases

The difference between tremor and Parkinson's tremor can be determined after a thorough neurological examination. Signs of neurodegenerative disease and the characteristics of trembling provide an opportunity to diagnose Parkinson's disease and other conditions.

Distinctive signs of Parkinson's disease

Important! Parkinson's and essential tremor are similar in clinical features, but different in etiology. An accurate diagnosis is necessary to determine treatment tactics and monitor the patient.

When hands shake in Parkinson's, it is necessary to predict the appearance of other severe symptoms - limitation of movements (hypokinesia) and muscle rigidity, since these are the ones that cause severe disability.

Manifestation of the disease at a young age

The idea that Parkinson's syndrome is characteristic only of older people is erroneous. There are cases when the disease occurs in young people aged 20-45 years, and is called early parkinsonism. Of the total number of registered cases, early parkinsonism accounts for 10%. Symptoms are unusual, which makes diagnosing the disease difficult.

Genetic factors coupled with external ones have a great influence on the possibility of manifestation. Not only the neurons responsible for movement are affected, but also other parts of the brain, so at a young age the disease manifests itself not only as motor disorders.

In young people, the disease has a sluggish, mild development. In old age, the disease develops more rapidly. The presence of chronic diseases and general health also affects the course of the process.

Atypical symptoms include:

• Dystonia is painful contractions of the muscles of the limbs. A doctor may confuse such manifestations with arthritis of the joints, which makes diagnosis much more difficult.
• Dyskinesia - involuntary twitching and movements of the limbs, can occur due to taking dopamine-containing medications.

Treatment of tremor in Parkinson's disease

Reducing tremors in Parkinson's is more difficult than coping with increased muscle tension and limited physical activity. Traditional treatment with drugs based on levodopa (a substance that replaces the neurotransmitter dopamine) does not have a significant effect on tremors. Treatment for tremor in Parkinson's disease is individualized, as patients respond differently to therapy.

Treatment of tremor in Parkinson's is carried out using the following groups of drugs:

• dopaminergic (levodopa);
• dopamine receptor agonists (Pramipexole);
• anticholinergics (Cyclodol);
• antidepressants (Selegeline);
• beta-type adrenaline receptor blockers (Propranolol);
• neuroleptics (Clozapine).

To achieve a clinical effect, it is necessary to increase the dosage and combine medications. During treatment, side effects and complications may occur.

Dopaminergic drugs

Treatment of tremor in Parkinson's disease is carried out with the basic drug levodopa. In some cases, the drug does not affect tremors, but significantly reduces muscle rigidity and decreased motor activity. Increasing the dose may cause psychosis and mental impairment.

Dopamine receptor agonists

Pramipexole is one of the most effective drugs for treating tremors. The combination with levodopa can reduce tremor and improve the quality of movements. The combination of drugs makes it possible to avoid complications when increasing the therapeutic dose of levodopa.

Anticholinergics

Cyclodol is able to reduce tremors, but causes a number of adverse effects. The patient is concerned about dry mouth, urinary retention, development of glaucoma, constipation. Visual hallucinations and memory loss often develop.

Antidepressants MAO inhibitors

Selegeline has an effect on tremor at an early stage of the disease. A positive effect can be considered an improvement in mood and intellectual abilities.

Adrenergic blockers

Propranolol reduces tremor by 50-70%. Its use is limited if the patient has bradycardia (slow heart rate) and a decreased heart rate.

Neuroleptics

It has an effect in severe cases when other drugs are ineffective. Increasing the therapeutic dose causes depression of mental functions and blood complications (leukopenia, anemia, agranulocytosis). In this regard, long-term use of the drug is impossible.

Trembling is a symptom of Parkinson's disease that is difficult to treat. To increase the effectiveness of conservative therapy, the method of neurosurgical stimulation of subcortical structures (substantia nigra) is used.

How to improve the patient's condition?

If Parkinson's disease has been diagnosed, this means that the doctor will immediately prescribe medications. The rate of development of the disease, its duration, severity, stage, and chronic diseases in the patient’s history are established. Not the most powerful drugs are prescribed - Selegiline and Pramipexole. For the initial stage they will be quite sufficient. In addition, physiotherapy, a special diet and physical therapy are recommended.

In recent years, the high effectiveness of the drug Levodopa has been noted. Its active substances are converted into dopamine in the brain. This allows you to reduce tremors, relax muscles, and improve motor activity. With timely administration of the drug, even partially immobilized patients gain the ability to move normally. Unfortunately, after 5 years of constant use of this drug, it becomes ineffective. The patient may lose control of movements. Dosing does not restore previous activity.

Surgery is performed very rarely, in cases where the patient does not respond to drug therapy.

Even with the highest quality treatment, the disease will progress inexorably. Therefore, relatives and friends should inquire in advance where they can obtain specialized skills for caring for the patient.