Stages And Treatment Of Parkinson's Disease

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Parkinson's disease is a chronic progressive disease. The patient's condition gradually deteriorates over time. Although it is not fatal, it seriously affects the patient's quality of life. The treatment of Parkinson's disease patients should be carried out according to the stage. It is possible to prolong the honeymoon period. Therefore, it is necessary to choose the correct treatment method and scientific treatment in different stages of Parkinson's disease.

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1. Early stage of Parkinson's disease

At this stage, the movement disorder of Parkinson's disease is mainly in one limb or both limbs, there is no balance problem, and there is no serious cognitive impairment, neuropsychiatric symptoms, and other non-motor symptoms. The treatment of early Parkinson's disease focuses on factors such as Parkinson's disease type, age, and cognitive function.

Although the manifestations of early Parkinson's disease are not typical, "shaking", "stiff" and "slow" are alarm bells. The most common symptoms are mainly six: ① Counting banknotes: Resting tremor is often the first symptom, much like what we do when counting banknotes. ② Strange postures: With stiff muscles, people will have some "strange postures", such as leaning the head forward, bending the body forward, bending the arms and knees, etc. ③The characters become smaller: the handwriting vibrates or becomes smaller and smaller when writing, walking slowly and taking small steps. ④ Slow movement: The early fine movements such as unbuttoning buttons and tying shoelaces are slow, and then gradually develop into slow movements of the whole body. ⑤Mask face: stiff face, staring eyes, dyskinesia of mouth, pharynx, and palatine muscles. ⑥Love depression: In recent years, surveys have shown that nearly half of the patients have depression or sleep disorders, and 15%-30% of patients develop dementia in the late stage of the disease.

2. The middle stage of Parkinson's disease

At this stage, there are motor fluctuations, diminished efficacy, and end-of-dose phenomenon. There are midline motor symptoms, but balance disorders are not obvious, and there may be non-motor symptoms such as mild cognitive impairment.

The above-mentioned manifestations suggest that it has entered the middle stage of Parkinson's disease, and has also entered the so-called "progressive stage". A moderate increase in the type, dose, and frequency of medications taken during the original "honeymoon period" is required to maintain efficacy in improving motor function. This stage usually requires the combined application of two or more anti-Parkinsonian drugs.

3. Late stage of Parkinson's disease

At this stage, there are clear balance disturbances and frequent falls, requiring the aid of braces or supports, dementia, severe cognitive impairment, and hallucinations.

The treatment of advanced Parkinson's disease faces many challenges:

1. Deterioration of motor symptoms, frequent falls, and other midline symptoms with dopa resistance;

2. Movement fluctuations develop from predictable to unpredictable, with reduced movement and abnormal dance-like movements coexisting;

3. Symptoms such as orthostatic hypotension and hallucinations may worsen during the addition of compound dopas and dopamine receptor agonists.

Treatment of Parkinson's patients at different stages of the disease course

Due to the progressive nature of Parkinson's disease, with the development of the disease, the patient's ability to live and quality of life is seriously affected. At present, there is no reliable method to cure or reverse the progression of the disease. In the early stage of the disease, when motor complications have not yet appeared, we can improve motor symptoms through drugs and traditional Chinese medicine treatment, so that normal life will not be affected as much as possible.

In the advanced stage of Parkinson's disease, the patient's limb mobility and quality of life are seriously impaired due to motor complications. At this time, it is found that the effect of the drug "gradually deteriorates", and the phenomenon of on-off and end-of-dose gradually appear. At this time, the treatment goal should be a combination of various anti-Parkinsonian drugs, which can be combined with traditional Chinese medicine to relieve symptoms of Parkinson's disease, improve exercise and non-exercise complications, and improve the quality of life of patients.

In the late stage of Parkinson's disease, serious motor complications, such as dyskinesia, will occur, and non-motor symptoms will become more serious. On the basis of drug treatment, brain pacemaker surgery can be considered to improve motor symptoms and reduce medication use. dose.