Treatment of Parkinson's disease
They should be prescribed as late as possible because of the side effects they cause. Drugs are of two types.
It prescribed antiparkinsonian is first those with the ability to cross the barrier protecting the central nervous system (blood-brain) and have the ability to transform into dopamine in the brain.
The second class of antiparkinsonian drugs are molecules with the ability to be effective stimulate the receptors in the brain, in this case the dopamine receptors.
If drugs initially bring a real improvement ("honey moon"), they may eventually cause some severe motor complications, the most common are dyskinesias (difficulty performing movements) that occur in about 80% cases after the famous honeymoon period.
Anticholinergic drugs, which act primarily on tremor and hypersalivation (increase in saliva secretion) are also used. These drugs should be prescribed with caution to age 70.
Levodopa (L-dopa) is administered at escalating doses (for the suppression of symptoms), mainly when there is a slow movement and muscle stiffness.
Pergolide is indicated in Parkinson's disease in combination with L-dopa. However, some side effects were noted: nausea, hallucinations, hypotension (low blood pressure) at the beginning of treatment. The association with other drugs is against-indicated: slang derived from rye, certain antibiotics (macrolides), neuroleptics, breastfeeding also.
Physiotherapy (during the early stages of the disease) occurs against the rigidity and consists of a comprehensive rehabilitation of walking, balance, mobilization of all the muscles to the extent possible.
Stereotactic surgery is a procedure rare, proposed when there are tremors on one side and resistance to previous treatment.
Neurosurgical techniques are indicated for patients resistant to pharmacological treatment (with drugs) or having a persistent tremor, rigidity and major disorders of the motor.
Deep-brain stimulation is used in the advanced stage of Parkinson's disease. This technique is performed under local anesthesia and is likely to cause complications such as dysarthria, the functioning of muscles that raise the eyelid and the posture of the patient, in theory allows to stabilize symptoms and reduce the side effects of medications. The electrical stimulation is roughly the equivalent of thalamotomy therapy (intervention in the thalamus). His main interest is not to create the anatomical lesions in the brain, thereby reducing the risk of occurrence of complications. Generally, this stimulation technique is proposed for aged individuals.
Stimulation of the central nucleus of the thalamus is particularly intermediate proposed advanced stage; phase fluctuations "on-off".
Stimulation of the subthalamic nucleus is sometimes used.
Stimulation of the internal globus pallidus does not seem to give the expected results.
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