Parkinson's Disease

This chronic degenerative neurological condition affects up to one per cent of all 60-year-olds — a proportion that increases steadily with age. However, while Parkinson's disease remains incurable to this day, the associated symptoms are well manageable with medication, provided the condition is identified early.

Our experienced doctors are by your side for diagnosis and the immediately following therapy at all our locations.

For a diagnosis of Parkinson's syndrome, the following four neurological features must be present simultaneously. These are:

• Akinesia (freezing of movement)
• Rigidity (generalised muscle stiffness)
• Resting tremor (trembling at rest)
• Postural instability (tendency to fall when standing upright)

The trigger for all forms of the Parkinson's symptom complex is the death of nerve tissue in the substantia nigra. This brain region is closely linked to physical motor function. When nerve cells die here, a suppression of the motor system results. The abnormality also leads to a deficiency of the neurotransmitter dopamine, which exacerbates the motor problems. A simultaneously occurring imbalance of other neurotransmitters such as noradrenaline and serotonin also results in further symptoms that go beyond motor impairment (such as dementia).

The typical symptoms of Parkinson's syndrome are divided into those affecting motor function and additional complaints. The former include:

• Slowed movement
• A characteristic posture, comprising: flexed joints and a short-stepped, shuffling gait with a slightly forward-inclined trunk (hence frequent forward falls) as a sign of instability
• Generalised movement stiffness
• In later stages of the disease: increasingly small handwriting, reduced facial expression, and difficulty swallowing

Additional complaints include:

• Depression
• Sleep disturbances
• Constipation
• Impaired sense of smell, progressing to complete loss of smell
• Muscle and joint pain, particularly in the shoulder girdle
• In later stages: anhedonia, anxiety, dementia, excessive salivation, and bladder emptying dysfunction

Comprehensive therapy for Parkinson's syndrome at avi begins with early diagnosis. The underlying medical measures include:

• Taking a medical history
• Orientating neurological examinations of gait, specific movement sequences, and reflexes
• In hospital additionally: MRI or CT scan to exclude other conditions

Diagnosis is followed by pharmacological treatment. This includes agents that:

• Contain the precursor to dopamine, thereby counteracting a deficiency
• Act in a dopamine-like manner
• Inhibit the breakdown of dopamine (MAO inhibitors)
• Alleviate muscle tremor (beta-blockers)
• Act against depression, dementia, and psychotic episodes (antidepressants, antidementia drugs, and antipsychotics)

Alongside the long-term use of these agents, regular laboratory monitoring is carried out to detect any possible side effects at an early stage.

Pharmacological treatment is further supported by the following measures:

• Physiotherapy
• Speech and language therapy
• Occupational therapy
• Music and art therapy