Parkinson's Treatment

Possible to distinguish roughly three in the treatment of Parkinson's disease: drug treatment, drug treatment and non-surgical treatment. First, start with general principles. The first step in treatment, to admit that it has a permanent brain disease. Will not exceed the disease is necessary to know and learn to live with it. Methods we have patients who survive for many years with a good quality of life possible. Some simple precautions and rules to be followed by their claims in the hands of their lives easier. Patients if they knew the characteristics of the disease, the life, activities, movements can shape according to him. For example, fatigue is a characteristic of Parkinson's disease and about half of Parkinsonluların complain of fatigue. If the patient knows this, configure a better day. We recommend that patients aşmamalarını fatigue limit. Home of women are a classic method. "All my work in the morning I do my strength, oturayım afternoon, and rest." But we do not recommend it. "Divide the Day. The morning, do the cooking, cleaning, do the afternoon, evening, or leave a little business" call. Yorulduklarını hissederlerse, to submit, and then re-initiate the search, as well as regular exercise, walking is recommended. This is a part of therapy for us. Would like to submit surely lose weight. Because the weight is already a normal person can create the problem. If the brain is ill, then more weight may become even more problematic. We recommend a healthy diet. Parkinson's disease do not have its own diet. Some medications taken with protein foods is absorbed more difficult, exceed the brain. Receiving the drugs for him, we recommend the consumption of protein foods, drugs and after a certain period. In addition, a healthy diet that apply to all people, also applies to Parkinson's ill. We want our patients to stay active both physically and mentally. Karşıyızdır completely withdraw into a corner. With modern methods of treatment of Parkinson's patients participate in daily life and business life are not an issue. Physiotherapy are also useful for patients who can not exercise on their own.
Dopamine and levodopa feature

Treatment of Parkinson's Disease Drug Treatment How is it done?

Alzheimer'da as drug treatment for this disease directly and non-specific forms of the disease have the original. Disease-specific treatment in the main strategy is to replace dopamine in the brain is no longer produced enough. Dopamine itself is not published. This is because the blood-brain dopamine aşamaması seddini. Normally, a barrier between blood and brain, there is a set of "blood-brain Great Wall" is defined as. Each substance in the blood to the brain can not. But they want to choose your own brain is. Dopamine is one of the substances can not pass to the brain. In this article we give the front of dopamine treatment. This substance called levodopa. Last levodopa to the brain, dopamine is converted and stored to be used by the brain cells that produce dopamine is started. We do not as a pure Levodopa'yı. Because we do so, out of brain cells in PD, dopamine is converted, for example, gastro-intestinal system. This is something we do not want that because it causes side effects. Levodopa'yı, converter converts dopamine (enzyme) together with a substance suppresses the offer, but this article does not pass to the brain, only the surrounding tissue remains.

Thus, we also levodopa, dopamine çevrilmiyor surrounding tissue and the majority goes to the brain. Rendered and are starting to be used after the brain dopamine. This drug is currently being considered as the most effective treatment of Parkinson's disease. Levodopa is a substance used since the early 1970s the end of 1960.

However, there is an observation as follows. For many years, patients treated with levodopa, some problems can occur, especially in young patients. For example, within five years after the initiation of treatment of patients with shorter duration of action of the drug in 50 percent of the 40-see. The patient says, "In the past when I bought ilacımı, no deterioration until the next dose hissetmezdim. But the second time in recent years, getting a dose of feel kötüleştiğimi approaching, increasing stiffness, slow to walk, starting to close." We call it the "motor (movement) fluctuations," or "cut-out periods' call. The patient in the context of the ability to act in a clear, going on an off. One of our dyskinesia or involuntary movements," we call a situation can occur. Sick of opening or closing is open to all entering the period of time or during the bending, bending, throwing, involuntary movements are emerging in the form of contraction. They are thought to be the following mechanism: At the beginning of brain dopamine levodopa'yı turning away from the blood, store and use at any time. But as time Scroll to the death of dopamine cells in the disease decreases with increasing storage capability. So if you have the brain at that moment in the blood how to take it and use of levodopa. so if you have the blood, using a lot away. In this case, the patient can walk, but can move as well as involuntary, the extra movements emerges. That these two complications, and off-off periods and on the modern treatment of levodopa-based drugs because of diskinezi'lerden delaying use in young patients. yeğliyoruz Instead, use other drugs before.

Now we understand better than ever, this does levodopa'nm complications, probably due to way we use our drug. Dopamine in the brain continuously salgılanıyor. However, we levodopa'yı outside a discontinuous way, from time to time offer, which interrupted the release of dopamine in the brain cause. The required warning is coming to the brain for a while, then disappear for a while. I mentioned these complications, we think he was born in the administration of intermittent levodopa'nın. For him, levodopa'yı more seamless, more constant question of whether we believe these issues do not currently being investigated. We have a drug that provides in part that, we are in an international study about him is still walking.

What this teacher work? When it began and when the result?

This is a more constant blood level of drug levodopa'nın kavuşup an additive that allows the brain to reach a more regular and continuous (entacapone) there. Levodopa'yı patients receiving conventional manner, the patients in this way kıyaslıyoruz. Approximately 800 patients in this study all over the world attending. The results will emerge within two years. If the brain levodopa'nın more continuous, less thought has occurred intermittently depending on the complications of this treatment be lowered to the timing of levodopa, the use of perspective will also change.

Our second group of drugs, the group defined as dopamine agonists. Binding to dopamine receptors in the brain creating its wider impact of these drugs, are a kind of mimic its effect. In this group there are different drugs (bromocriptine, pergolide, lizürid, cabergoline, pramipexole, ropinirol, pribedil) and all are in Turkey. We prefer to start them young age in patients, at birth need to add levodopa'yı treatment.

Do not have obtained any other weapons?

There are also another group of drugs. One of them antikoliner-jikler. Action of dopamine in the brain called the basal ganglion'laı carrier with the message of a chemical which has a balance between acetylcholine. Dopamine decreased when the amount of acetylcholine remains relatively high. Dopamine-acetylcholine balance by reducing the effect of Anticholinergics asetilkolin'in partly re-establishment offers. This group of young people and shake the forefront of the use in patients. Elderly patients do not prefer, because of memory impairment, confusion are able.

What is the latest in the Treatment of Parkinson's drugs?

These "enzyme inhibitors" is a group we call the two different flavors: "COMT enzyme inhibitors," and "MAO enzyme inhibitors." The first group of drugs to the brain by blocking the effect of the use of the adjacent tissues outside the brain levodopa'nın increase the amount of levodopa reaching the second group, the brain cells produce dopamine levodopa'dan reaching their own his or outside. in the brain by preventing the destruction of drugs to ensure a longer stay. The second group includes both alone and levodopa can be used with other drugs. COMT inhibitors, the drugs that contain only levodoa they work together because their purpose is to provide access to the brain is already more levodopa'nın.

Is there an alternative to giving the oral medication? Yes, there are methods of making any other kind of drugs. For example, thanks to a newly developed method of levodopa, inserted into the abdomen small, intestine duodenum through a cannula can be given continuously. Drug absorb when given directly into the intestine can be provided a continuity and regularity. However, in a way that is quite troublesome. Another one of agonistler'inden dopamine (apomorphine), a thin needle is inserted under the skin and programmable, so you can adjust the amount of drug given through a small pump continuously given to the body and to ensure continuity of the brain dopaminergic stimulation. This method is incapable of motion in patients living in the problem of fluctuation is quite works. Or the sudden closing of patients with the same drug on their own they can be applied in the form of single injections. Given such a short period of drug effect is 5 minutes, until the effect takes 1-2 hours to half. During that time also, for example, are external and off the patient gets the chance to go home. There is another emerging method. This is yet another dopamine agonist'inin (rotigotin) given once a day through the skin in the form of a tape pasted.

Also said that non-specific methods of treatment for the disease, what they are?

For example, depression medications. In these patients, depression often told rastladığımızı. The patient's age, other bodily diseases, and used other drugs by looking at whether we decide that we will choose which of depression medication. Or the patient's dreams, delusions have been using drugs used in schizophrenia. Mental disorders caused by Parkinson's disease and Par-kinson dementia group also started to use a new drug. Our clinic is a major international study coordinated with the use of Alzheimer's disease so far, "cholinesterase inhibitors" of a drug group (rivastigmine) have shown that Parkinson's disease caused by the bunamada useful.

There is talk also is useful in a pod, right?

Fresh broad beans, the above-mentioned eniğimiz significantly, dopamine precursor which contains leuodopa. There are approximately 135 milligrams per gram leıvdopa fresh pod 40-50, that is, drugs we give our substance naturally present in the pod. But the pod does not replace any form of drug treatment. Provided that a few hundred grams of fresh bean Yoğurtsuz day cut-out, especially in patients who can stay open longer. However much they beat the emergence of adverse effects, including involuntary movements especially in the cause.

Parkinson's surgery

Drug treatment told, it's time for surgery.

In fact, a very old history of surgical intervention is based, was first applied in the 1940s. Then, with the emergence of effective drugs removed from the rack. Surgical methods since the early 1990s started to become popular again, especially levodopa'nın involuntary movements caused by long-term use in patients with yarayabileceği after being presented with numerous jobs. Mechanism on the basis of surgery, there are: some of the centers of the brains of Parkinson's disease, dopamine deficiency as the more trying. Characteristics of these centers are more suppressive when they work, under their control and to act in the brain regions necessary to give the last orders baskılıyorlar. The aim of surgery in uncontrolled areas of Parkinson's less work than trying to make it. For this purpose, two different methods are applied. One of them is destructive (devastating), or "burn surgery," say, the second is the "deep brain stimulation" or "with electrode stimulation," or "Battery insertion surgery call. Uyutulmadan Both methods are applied to the patient.

Incineration is applied and how the success of surgery?

High-frequency radio waves in the region working with partially dağlanıyor more. This method, for example in patients with shake it just works. But it also has some limitations. First, this region of the brain damage and you want to give it more yaktıysanız damage can be permanent. Is going to want at least a temporary effect yaktıysanız. For example, patient 3 months, 6 months is going well, but then another problem arises again if the symptoms of burning double-sided yapılamaması. Let's say that on the one hand was trembling so, that way you implement for the incineration surgery. The risk of unilateral intervention is quite low, around 3-5 per cent. But this time the patient began to shake the other side. Also when you want to burn it there, rising to 30 percent of the risk of occurrence of complications and they are serious risks, speech impairment, balance impairment, degradation, such as swallowing. For her "devastating surgical" useful, but often a one-sided method is applied. Especially in patients with tremor and involuntary movements of works.
Parkinson's surgery is basically aimed at 3 different centers. Where intervention will be determined by the patient's complaint. The second method, the surgical intervention centers in the brain are similar. Here, the center of the target rather than burned electrodes, high-frequency stimulation of being held captive.

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