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Boala Parkinson

Boala Parkinson este o afectiune degenerativa a creierului, asociata cu inaintarea in varsta. Boala Parkinson afecteaza grupuri de neuroni care sunt implicati in miscare, unde neurotransmitatorul numit dopamina faciliteaza emiterea semnalelor la nivelul sinapselor neuronale. Un prin semn tipic este tremuratul usor, in repaus, ce apare de multe ori, initial pe o singura parte. Este un tremor cu miscari scurte si care se reduce la miscare voluntara. Afecteaza ambele parti ale corpului, implican mainile, picioarele si mandibula. Incetinirea miscarilor este, de multe ori, primul semn sesizat mai repede de familie decat de pacient. Rigiditatea musculaturii se adauga la tabloul general, incetinind miscarile si dand un aspect de mers sovaitor si instabilitate postulara. In mers, se remarca o scadere a miscari bratelor pe langa corp. Pacientul prezinta o vorbire monotona, o lipsa de expresivitate a fetei si apar scurgeri de saliva, din cauza dificultatilor la ing itire. !usc ii devin durerosi si apar crampe, de multe ori apare oboseala, iar constipatia este un simptom obisnuit la acesti pacienti. "crisul lor devine mic, tremurat si dezordonat, din cauza rigiditatii instalate. #data cu evolutia bolii, poate sa apara un grad ma$or de invaliditate, in care pacientul poate a$unge imobilizat in scaun. Aceasta situatie poate duce la complicatii, precum pneumonia, escarele si infectiile tractului urinar. !a$oritatea pacientilor isi pastreaza functiile intelectuale intacte, dar cu timpul, la unii dintre ei pot sa apara modificari mentale structurale. Diagnostic %iagnosticul se pune, in intregime, pe aspectul clinic, care este, de obicei, caracteristic. Este necesara o cercetare a istoricului bolii in detaliu si o examinare clinica atenta, pentru a exclude cauzele parkinsonismului. Acestea pot fi& !edicamentele& fenotiazinele, rezerpina, metildopa' Infectiile& urmate de inflamatia creierului' (oxinele& monoxidul de carbon si manganul' )ipotiroidismul' *asculare& bolile cerebrovasculare' (raumatismele craniene' +ombinatia cu alte afectiuni cum ar fi Alz eimer' Cauze si prognostic "tudiile de microbiologie nu au reusit sa descopere o cauza infectioasa a acestei boli. Principalele modificari patologice ce apar in boala sut degenerarea

tesutului cerebral, prezenta in celulele creierului a unor incluziuni de dimensiuni mari si disparitia neuronilor in zone importante ale creierului. Aceste descoperiri au dus la instituirea tratamentului cu ,-dopa, pentru a inlocui dopamina pierduta de creier.
Boala este, de obice, progresiva si pacientii pot deveni cu timpul imobilizati la pat sau in scaun, din cauza rigiditatii. #data cu introducerea tratamentului cu ,-dopa, speranta de viata a bolnavilor de Parkinson a crescut semnificativ. %urata medie de supravietuire din momentul depistarii bolii, este de ./ ani. Tratamentul medicamentos (ratamentul specific implica folosirea medicamentelor antiparkinsoniene. %e obicei se incepe tratamentul devine atat de severa incat perturba activitatiile zilnice. (ratamentul incepe cu pastile de ,-dopa, in doza mica, asociate cu un in ibitor periferic de dopa decarboxilaza. Pacientii care raspund bine la administrarea de ,-dopa ar putea constata ca efectul terapeutic al fiecarei tablete devine tot mai scurt, ceea ce duce la variatii in simptomatologia bolii. (ratamentul de sustinere 0 terapia ocupationala si psi oterapia sunt elemente importante prin care bolnavul este a$utat sa isi pastreze independenta in activitatile zilnice pentru o perioada cat mai indelungata. (ratamentul simptomatic 0 constipatia ar putea necesita tratament, la fel si de presia sau durerile musc ilor sc eletici. Boala Parkinson afecteaza aproximativ . din .1111 de persoane. %upa varsta de /1 de ani, prevalenta bolii este de . la 211. Procentul este putin mai mare la barbati decat la femei si nu pare sa aiba transmitere familiala.

Parkinsons disease
Parkinson3s disease is a degenerative disorder of t e brain associated 4it aging . Parkinson3s disease affects groups of neurons t at are involved in movement , 4 ere t e neurotransmitter dopamine facilitates issuing signals at neuronal s5napses . A t5pical first sign is s aking slig tl5 , at rest , 4 ic often occurs initiall5 on one side . It is a s ort movements and tremor 4 ic is reduced to voluntar5 movement. It affects bot sides of t e bod5 involved ands, feet and $a4. "lo4ness of movement is often t e first sign noticed b5 t e famil5 faster t an t e patient. !uscle stiffness adds to t e overall picture , slo4ing movement and giving t e appearance of 4alking unsteadil5 and instabilit5 postulation . In 4alking , t ere is a decrease in t e movement of t e arms at 5our sides . ( e patient s o4s a monotonous speec , a lack of expressiveness of t e face and drooling occur due to s4allo4ing difficulties . !uscles are painful and occur cramps, often occurs fatigue and constipation is a common s5mptom in t ese patients. ( eir 4riting becomes small , trembling and mess5 due to t e rigidit5 installed . 6it t e evolution of t e disease ma5 occur a ma$or degree of disabilit5, t e patient can get immobilized in t e seat . ( is can lead to complications suc as pneumonia, pressure sores and urinar5 tract infections . !ost people keep t eir mental functions intact , but over time ,to some of t em mental structural c anges can occur . Diagnosis %iagnosis is put entirel5 on clinical appearance , 4 ic is usuall5 c aracteristic . Researc is needed to disease istor5 in detail and a careful clinical examination to rule out causes of parkinsonism . ( ese include& 7 drugs & p enot iazines , reserpine , met 5ldopa ' 7 Infections & follo4ed b5 inflammation of t e brain' 7 (oxins & carbon monoxide and manganese ' 7 )5pot 5roidism ' 7 *ascular & cerebrovascular diseases ' 7 )ead trauma ' 7 +ombination 4it ot er disorders suc as Alz eimer3s ' Causes and prognosis !icrobiological studies ave failed to reveal an infectious cause of t e disease . ( e main pat ological c anges t at occur in brain tissue degeneration, t e presence in brain cells of large inclusions and disappearance of neurons in

areas of t e brain. ( ese findings led to t e treatment 4it , - dopa to replace lost dopamine in t e brain. ( e disease is usuall5 progressive and patients ma5 become bedridden during time or to c air because of stiffness . 6it t e introduction of , - dopa t erap5 , t e life expectanc5 of Parkinson3s patients increased significantl5. ( e median time from t e detection of t e disease is ./ 5ears . Drug treatment "pecific treatment involves t e use of anti-parkinsonian drugs . Usuall5 begins treatment becomes so severe t at disrupt dail5 activities . (reatment begins 4it , -dopa pills , lo4 dose associated 4it perip eral dopa decarbox5lase in ibitor . Patients 4 o respond 4ell to t e administration of , - dopa ma5 find t at t e t erapeutic effect of eac tablet becomes s orter, 4 ic leads to variations in disease s5mptoms . "upportive t erap5 - occupational t erap5 and ps5c ot erap5 are important elements t at t e patient is elped to retain independence in dail5 activities for as long as possible . "5mptomatic treatment - constipation ma5 re8uire treatment , as 4ell as pressure or musculoskeletal pain . Parkinson3s disease affects about . in .1,111 people . After t e age of /1 5ears , t e prevalence of t e disease is . in 211 . ( e percentage is slig tl5 ig er in men t an in 4omen and it does not seem to ave familial transmission .