- I have Parkinson's.

Special requirement in therapy is the high frequency of medication intake. Medication intervals of 9 doses per day are not uncommon. It is easy to understand that this can become a common problem for very pragmatic reasons. Fortunately for patients, their family and caregivers, create modern tools such as our automatic Pill machine CAREOUSEL, a great extra convenience.

With the precision of a clock, it reminds you of the punctual recording by both acoustic and optical signal. Parkinson patients will benefit from the fact that the medication can even be sorted with high intake intervals for several days. No less important is the GSM emergency call function integrated into the CAROUSEL Advance model. If the tablet box is not upright and tilted to the side, it immediately sends an SMS to previously stored mobile phone numbers.

Important for understanding the disease: Based on the symptoms three typologies:

The occurrence of reduced mobility (ackinesia), the shaking (tremor dominant) and the similar to about the same pronounced movement restriction and blurring, Important in medical diagnosis is the demarcation of symptoms against other neuronal disorders. In itself, the symptoms do not necessarily mean Parkinson's disease. On the other hand, atypical Parkinson's symptoms do NOT automatically indicate that it is not Parkinson'S.

Causes of Parkinson's?

Despite centuries of medical research, the cause of Parkinson's disease is still elusive and verifiable. Against this background, an idiopathic disease is mentioned (without tangible cause).

All explanations and causal theories are hypotheses so far, and there are several: since it has been discovered that the disease is more common in some families, one of them is that genetic causes are responsible for their development. As a separate explanation, this theory refutes itself as far as there are many patients with Parkinson's disease without hereditary predisposition.

Symptoms of Parkinson's disease

If a disease is determined by different characteristic symptoms, it is called a syndrome. Similarly in Parkinson's: The relevant cardinal symptoms are hypokinesia, the inertia of movement in the medical jargon, as well as stiffness (muscle stiffness) and vibrations known as tremor. Moreover, the postural instability is called postural reflexes. There are other typical characteristics used in an exclusion diagnosis.

Parkinson's syndrome

The course of Parkinson's disease is unpredictable, and the rate of development varies from person to person. It is clear that the life expectancy of Parkinson patients differs at most from that of healthy people. However, due to immanent motor and non-motor symptoms, Parkinson's disease is associated with increasing risks of complications as the condition progresses. And these can be life-threatening: for example, the risk of uncontrolled falls due to limited mobility. Daily activities such as cutting vegetables may be dangerous because of the damaged fine motor skills.

The progressive course of the movement disorders is increasing. Clearly, the changing pattern of movements is visible. The affected people try to compensate for their progress and compensation for uncertainty by taking small steps. The passage through narrow passages becomes increasingly a problem. Uncertainty develops a need for help. Also, the way of speech changes into a more monotonous and silent expression. Besides speech disorder and swallowing disorder, facial expressions are also reduced.

Therapy cannot treat the causes, but it can relieve the symptoms. However, the commonly used medicines have side effects. And they are increasing noticeably over time. This in turn has to do with the wear - the weakening effect of the medications. To achieve the same effectiveness, more and more Parkinson's medicines need to be taken in the long term. This inevitably leads to increased side effects, which are not always the case.

Parkinson's therapy without medication

Especially because the cause of Parkinson's disease is unclear, drug-free therapies can only be supportive. Prophylaxis is not possible. Nevertheless, it makes sense to counteract disease-specific symptoms with a healthy lifestyle, which ensures a more resistant disposition. Important as guidance on medical treatment is physical therapy. The goal should be to re-activate patients'partially lost skills and, ideally, to avoid further loss of movement, normally to slow down course.
The therapists rely on physical therapy, speech and logo therapy and swallowing therapy. The very pragmatic objectives are based on disease-specific symptoms: appropriate therapeutic measures should prevent accidental falls and the affected should learn how to handle everyday aids such as a rollator. In addition, facial expressions are trained to enable the patient to control his or her own features. The bottom line is therefore targeted exercises to use existing skills.

Treatment of Parkinson's disease

Now that the medications are available, many patients with Parkinson's disease can continue their lives without enormous restrictions. Because of the gradual progression of the disease it is important that the medicine is always adapted to the current condition.

L-Dopa preparations - levodopa- are considered the basis of Parkinson's disease therapy. These drugs start with the main aspect of the disease par excellence: dopamine deficiency. Levodopa is converted directly into pure dopamine in the body, thus increasing the level of dopamine again. The difficulty is that these medicines should reach the intended location in the system, only the brain, especially the substantia nigra. In addition, L-dopa can cause significant side effects on heart problems. The solution is in combination with the carboxylase inhibitors. The inhibitor can have two important benefits

The treating physicians are looking at the lowest dose possible in L-dopa medication. Only this way can the fairly significant side effects be controlled. At the same time they should face the fact that levodopa's duration of action is decreasing continuously over time, which should again increase medication with even more significant side-effects.

In response to this fact, hardly any kind of amiable fact is happening early after the presence of so-called dopamine agonists. These preparations mimic the effects of dopamine. The brain is somewhat "deceptive" with a small trick. The body's own dopamine receptors do not recognize any difference between real dopamine and synthetic replacement. The benefits are the long term less side effects, also the consistent strength and low income frequency for medication.

The medication in both therapeutic variants is in most cases supported by other preparations. With MAO-B & COMT inhibitors, the breakdown of dopamine is delayed so that the neurotransmitter is present longer in the body. Similarly, glutamate antagonists are used. Glutamate is one of the substances that should always be in line with dopamine. Excessive amounts of glutamate can negatively affect typical tremor of the disease. The messenger substance acetylcholine is also disproportionate in the brain of Parkinson patients. Anticholinergica reduces the excess and restores the natural balance here too.

A new approach to the cure of Parkinson's disease is medicine and research in stem cell therapy. The method is not yet recognized and is still ethical in discussion. Nevertheless, it seems promising in the medium to long term. The treatment approach is to replace the destroyed cells in the Substatia nigra with healthy stem cells to re-activate the dopamine production of the body. At this moment a very interesting hope for dopamine producing cells from the rhetort of genetic manipulation, which is also supported by the federal Ministry of Research. Whether and when the future music of genetic research