帕金森症 疾病

迹象 & 症状

帕金森症 generally progresses slowly, sometimes taking years for 症状 to appear. 这种疾病 usually strikes adults over age 50, although it has been diagnosed as early as age 20. About 15 percent of 帕金森症 patients have a family history of the disease.

Because it develops gradually, most people have many years of productive living after being diagnosed.

Some of the first 症状 commonly experienced with 帕金森症 include the following:

• 刚性 Arms and legs become stiff and hard to move
• 震动 Rapid shaking of the hands, arms or legs
• 放慢动作 Difficulty starting or completing movements, called bradykinesia
• 受损的平衡 Lack of balance or difficulty adjusting to sudden changes in position

These 症状 may make it difficult for you to walk, pick up and hold things, 吃, 写, or react quickly to prevent injury if you fall.

Other 症状 include difficulty speaking or swallowing, 流口水, 弯腰的姿势, inability to make facial expressions, 油性皮肤, cramped handwriting, shortness of br吃h, 便秘, increased sw吃ing, erectile dysfunction, difficulty sleeping, problems urinating and anxiety.

诊断

A diagnosis for this disease generally includes an assessment of 症状 and a series of tests. There is no single test to clearly identify the disease.

Tests administered may include:

• Blood or urine tests
• An electrocardiogram (ECG)
• x射线
• Other imaging tests, such as a positron emission tomography (PET) scan 或者一个 magnetic resonance imaging (MRI) scan.

The imaging tests are generally quick and painless. They use diagnostic cameras and recording devices to produce images of organs and tissues inside your body.

If you've been diagnosed with 帕金森症 already, these tests can help determine if you have the classic form 或者一个n atypical form of the disease.

If you doctor suspects you have 帕金森症 disease, he or she may prescribe anti-帕金森症 drugs to see if you respond.

治疗

药物治疗s can provide dramatic relief from 帕金森症 症状, but no drug can stop the progression of the disease. In some cases, surgery is an option. Some doctors recommend 物理治疗 or muscle strengthening. For many patients, a combination of these approaches works best.

药物治疗

左旋多巴, combined with another drug called carbidopa or Sinemet, is the mainstay of 帕金森症 therapy. 左旋多巴 is rapidly converted into dopamine by the enzyme dopa decarboxylase (DDC), which is present in the central and peripheral nervous systems. Much of levodopa is metabolized before it reaches the brain.

Because these drugs are known to cause side effects and can become ineffective after prolonged periods of use, 其他药物, such as dopamine agonists, 金刚烷胺, COMT inhibitors and anticholinergic medications also are used to tr吃 帕金森症 disease.

手术

When medication is ineffective, surgery may be an option to control 症状 and improve quality of life. However, not everyone is a good candidate for surgery. 例如, if a patient never responded or no longer responds to levodopa and carbidopa, surgery is unlikely to help. Only about 10 percent of 帕金森症 patients are candidates for surgery.

Three surgical procedures are performed to tr吃 帕金森症 disease — ablative or destructive surgery, stimulation surgery or deep brain stimulation (DBS), and transplantation or restorative surgery.

• 烧蚀手术 This procedure locates, targets and then ablates or destroys a targeted area of the brain affected by 帕金森症. The object is to destroy tissue that produces abnormal chemical or electrical impulses that cause tremors and other 症状 of 帕金森症. A lesion of the globus pallidus, called pallidotomy, is the most common ablative surgery for 帕金森症 disease.
• Deep Brain Stimulation (DBS) Like ablative surgery, deep brain stimulation surgery tr吃s the tremors and slowness associated with 帕金森症 disease. The procedure involves inserting a deep brain stimulator into certain areas of the brain. Instead of destroying the overactive cells that cause 症状 of 帕金森症, DBS temporarily disables them by sending pulses of electricity. This therapy has been shown to provide gr吃er relief of 症状 with fewer side effects than other tr吃ments.
• 移植 In transplantation or restorative surgery, dopamine-producing cells are implanted into a certain part of the brain. The cells used for transplant may come from one of several sources — the patient's body, human embryos or pig embryos. Using stem cells for this procedure is currently being researched.

Complementary 治疗

Complementary or integrative care combines the best of alternative therapies — such as acupuncture, 按摩, 冥想, herbs and nutrition — and conventional medicine. A number of tr吃ments such as simply physical activity, 物理治疗, 按摩 and support groups can help relieve 症状 and improve quality of life. Discuss with your doctor the possible tr吃ments he or she recommends to tr吃 your 症状.