Experts state that Parkinson's disease, which is defined as "a progressive disease characterized by problems such as slowing down in movements, tremors, gait disruption and falling", begins insidiously and unilaterally, and therefore it is difficult to notice. Noting that when the doctor was consulted, it was determined that the disease had started 1-2 years ago, experts emphasize that fasting in Parkinson's disease is medically inconvenient due to the use of drugs. Experts point out that fasting can lead to a state of inactivity called 'freezing' and hospitalization in the patient.
April 11 is celebrated as World Parkinson's Disease Day every year in order to create social awareness and raise awareness.
Üsküdar University NPİSTANBUL Brain Hospital Neurology Specialist Dr. Celal Şalçini, in his statement within the framework of World Parkinson's Disease Day, touched upon the types, symptoms, diagnosis and treatment processes of the disease, as well as the drawbacks of fasting during Ramadan and shared important recommendations.
When the disease is noticed, 1-2 years have passed.
Stating that Parkinson's disease is a very old disease and named after the person who found it, Neurology Specialist Dr. Celal Şalçini said, “It is a progressive disease that is generally characterized by problems such as slowing down in movements, tremors, gait disruption and falling. It starts insidiously and one-sided at first, it is difficult to notice. When the patient already consults the doctor, the disease starts 1-2 years ago. As a result of a deficiency in the neurotransmitter structure in the brain or the damage that occurs during this path, Parkinson's begins in the person. said.
There are 2 types of classic Parkinson's
Expressing that there are 2 different types of Parkinson's, akinetic rigid and tremor dominant, Neurology Specialist Dr. Celal Şalçini said, “It can be defined as Parkinson's that progresses slowly and Parkinson's that progresses with moving tremors. Sometimes these two Parkinson's can start at the same time, but this is rare. Regardless of the type, both shaking and slowing start unilaterally. After a while, it moves to the other side and becomes two-sided. It is possible to get a response to treatment in Parkinson's, which goes with slowing down. In Parkinson's with tremor, it is a little more difficult to stop the tremor and requires higher doses of medication. Of course, in addition to tremors, disorders such as forgetfulness, certain problems and brain thinning may occur in advanced stages. These are classic Parkinson's disease." he said.
Poker Pay attention to facial expression…
Stating that Parkinson has additional syndromes called Parkinson Plus, in addition to akinetic rigid and tremor dominant, Neurology Specialist Dr. Celal Salçini continued his words as follows:
“The general feature of these disorders is that they are not as smiling as Parkinson's. The treatment of the disease is difficult, they are more unresponsive to drugs, their course is more severe and progresses faster. They don't just continue with Parkinson's findings. In addition to the symptoms of Parkinson's, symptoms such as autonomic system disorder, upward gaze limitation, hand use problems, convulsions, imbalance, shrinkage of the cerebellum, and shrinkage of the crustal layer in the brain can be seen in the early period. When we see patients with this Parkinson's disease, we encounter some symptoms. First of all, they have a dull expression on their faces. The use of mimics has drastically decreased. It is referred to as "poker facial expression" in the books. The patient has a decrease in the number of blinks. There are injuries and crusting on the facial skin. They usually walk in small steps, leaning forward. They have imbalances and there is a risk of falling.”
Medication is used to confirm the diagnosis.
Stating that the examination will be sufficient to diagnose Parkinson's, Neurology Specialist Dr. Celal Şalçini said, “At this point, it is important that the examination is done well. Getting help from imaging devices and getting support from blood tests in the same way are of great importance. We want to exclude them all. Because Parkinson's can also cause a sudden clot in the brain. It can also lead to the formation of certain substances, such as copper deposition. Therefore, images of the patient will be needed for differential diagnosis. In Parkinson's disease, medication is started to confirm the diagnosis. If the medicine works, it's definitely Parkinson's. If the medicine doesn't work then the ailment is Parkinson's plus or a different disease. This condition is called test therapeutic, which is a French term. In other words, the physician can sometimes go from medicine to diagnosis. According to recent studies, starting medication early in the diagnosis of Parkinson's disease has no effect on the life of the patient. We diagnose the patient. Of course, early diagnosis is important, because the patient should know what kind of ailment he has. But even with early diagnosis, we delay drug treatment.” said.
Increasing the quality of life with medication
Stating that Parkinson's treatment is not possible, but the drugs given increase the patient's quality of life, Neurology Specialist Dr. Celal Şalçini said, “Medicines at least prevent the patient from trembling and slowing down. Thus, the patient can continue his life normally for a long time. The strategy followed here is: When drug treatment is started to the patient, the dose is started as low as possible and the dose is increased in line with the patient's needs. Because these drugs have side effects. These side effects are dose-related and time-dependent. In other words, the higher the dose and the longer a patient uses high-dose medication, the higher the potential for side effects.” said.
Fasting is inconvenient for Parkinson's patients.
Noting that in Parkinson's disease, it may be necessary to administer drugs three or more times a day, sometimes even with 3-4 hour intervals, Neurology Specialist Dr. Celal Şalçini said, “It is medically inconvenient to fast, especially in these situations. Sudden discontinuation of drugs or dose reduction causes the patient's movements to slow down or tremors to increase too much. This slowdown can sometimes affect swallowing and cause the patient to remain immobile, which we call “freezing” in medical language, and may require hospitalization.” he said.
Genetic predisposition depends on many factors
Stating that a very small part of Parkinson's disease is inherited, Neurology Specialist Dr. Celal Şalçini said, “This familial Parkinson's is caused by family members and starts at a young age. It is learned through genetic tests, which are also available in Turkey. He has Parkinson's disease, which begins at age 45. Of course, the prognosis is bad because it is genetic. Medications are somewhat less responsive but fortunately rare. On the other hand, there is also a genetic predisposition. It is not certain, of course, many factors have to come together. There is a genetic background not only for Parkinson's, but also for diseases such as Alzheimer's that lead to the death of brain cells. However, genetic predisposition is not a factor that can be a factor alone. On the other hand, there are many hypotheses about how one's lifestyle triggers Parkinson's, but none of them are clear.” used the phrases.
The main symptoms are slowing down and shaking.
Reminding that slowing down and trembling are the main symptoms of Parkinson's, Neurology Specialist Dr. Celal Şalçini said, “Anyone who has tremors in the hand should definitely come to the examination. However, in the arm and leg, there is a situation that we call asocial movement, and the inability to move one limb and not the other. In this disease, there is also a slowdown in the mind. Tremors can have many causes. It doesn't have to be due to Parkinson's for sure. Examination is performed with the help of imaging devices. To be sure, help can be obtained from the EMG device. Then the diagnosis is made and the treatment begins.” said.
Patient, doctor and patient relatives should be in communication
Emphasizing that it is very important for the patient, the patient's relatives and the doctor to cooperate, Neurology Specialist Dr. Celal Şalçini said, “Because this disease is an incurable disease, mostly aimed at increasing the comfort of patients and their relatives. Here, the adaptation process and the doctor's ability to reach the patient are very important. Since it is a progressive disease, the patient needs to consult a doctor frequently. They need to be good observers. We usually ask the patient, 'Did the medicine we gave open you up?' we ask. In other words, the medicine we give should work on the patient within 30-40 minutes. The dose is determined according to the patient's response to the drug. he said.
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