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TREATMENT
People who are only mildly affected by Parkinson's disease may need no treatment at first. As symptoms progress, various treatment approaches are available.
Medication
Medication selection and dosage are tailored to the individual. The doctor considers factors such as severity of symptoms, age and presence of other medical conditions. Every patient responds differently to a medication or dosage level, so this process involves experimentation, persistence, and patience. As the disease progresses, drug dosages may need to be modified. Sometimes drugs are combined. Patients need to receive care from doctors who have extensive experience treating all stages of Parkinson's disease — increasing the effectiveness of treatment at every stage of the disease.
Levodopa, a substance normally found in the body in limited amounts, is usually the first medication prescribed. Taken orally, levodopa can be converted by the body into dopamine the body needs.
Another class of drugs, dopamine agonists, is also useful at reducing symptoms and can be used singly or in conjunction with levodopa. Dopamine agonists were introduced 20 years ago. Agonists are chemical substances capable of combining with part of a cell and initiating a reaction or activity.
In 1998, the first in a new class of Parkinson's disease drugs (COMT inhibitors) was approved by the Food and Drug Administration. The COMT inhibitors prolong effects of levodopa therapy by blocking an enzyme that can break down levodopa.
Surgery
In severely affected patients, surgical treatments such as ablation, deep brain stimulation, and pallidotomy may control some symptoms.
Ablation
This procedure locates, targets, and then ablates (destroys) a clearly defined area of the brain affected by Parkinson's. The object is to destroy tissue that produces abnormal chemical or electrical impulses that produce abnormal movements. This approach is done less frequently, in favor of deep brain stimulation.
Deep Brain Stimulation (DBS)
DBS targets areas in the brain where uncontrolled movements originate. The targeted region is inactivated, not destroyed, by an implanted electrode. The electrode is connected via a wire running beneath the skin to a stimulator and battery pack in the patient's chest.
Mayo Clinic has extensive expertise in determining which patients would benefit from the surgery. Read more aboutdeep brain stimulation.
Palllidotomy
Pallidotomy, (named for the pallidum area of the brain) is a delicate surgical procedure that targets a precise area to control certain symptoms. A fine probe measures abnormal electrical activity. Another probe delivers small electrical shocks. The patient, who is awake during the surgery, describes the effects to pinpoint the area for treatment. The surgeon then burns a tiny hole in the cells. Results are almost immediate.
Cerebral Transplantation
Dopamine-producing cells are implanted into the brain. The cells used for transplantation may come from fetal cells or embryonic stem cells.
At present, this surgery is experimental and much research needs to be done before it can be considered routinely. Mayo Clinic currently does not offer this surgery.
Complementary Treatments
Numerous therapies and nutritional supplements may help relieve symptoms and improve quality of life.
Physical therapy can help strengthen and tone underused muscles, and give rigid muscles a better range of motion. The goal is to help build body strength, improve balance, overcome gait problems and improve speaking and swallowing. Simple physical activities such as walking, gardening and swimming can foster a sense of well-being. For some patients, soothing massage may provide relief from muscle rigidity and may have other neuromuscular benefit(s).
Tomado de :http://www.mayoclinic.org/parkinsons-disease/treatment.html
GOBIERNO DE VICTORIA (AUSTRALIA)
Parkinson’s disease is a progressive neurological condition and is often referred to as a movement disorder. The symptoms include tremor, rigidity, slowness and impaired movement. With a combination of medication and multidisciplinary support, people with Parkinson’s can live independent and productive lives.
No two people have exactly the same Parkinson’s and no two people will have exactly the same treatment. Your doctor or neurologist can help you decide which treatments to use.
Medication
Symptoms of Parkinson’s disease result from the progressive degeneration of nerve cells in the middle area of the brain. This causes a deficiency in the availability of dopamine, which is necessary for smooth and controlled movements.
Most Parkinson’s medications fit into one of the following broad categories:
Talk to your doctor about your treatment
It is important to see a neurologist or a doctor who has experience in assisting people living with Parkinson’s disease. These are the best people to help you decide which treatments to use.
There is no ‘best’ drug treatment for Parkinson’s. Each person has different symptoms, disease progression, lifestyle and physical tolerances. All of these factors will affect the timing, type, dose and combinations of medication. As the disease progresses, your individual medication program will need to be reviewed and altered.
It is very important to take your medication at the recommended time and on time every day, whether you are at home, at work, in hospital or in a nursing home. Medications taken late can severely hamper the movements of people living with Parkinson’s.
How long does the medication last?
Medication will help to elevate symptoms but will not alter the progression of the symptoms over time. Over time, you may experience problems with your medication wearing off and may need to try different drug regimes to get the most benefit.
Seeing a neurologist regularly will help you to make sure you are getting the best possible medication management. A neurologist will manage your doses and any necessary adjustments. This is important as side effects can be a problem when on large doses.
Multidisciplinary support can help
Early access to a multidisciplinary support team is important. These teams may include doctors, physiotherapists, occupational therapists, speech therapists, dietitians, social workers and specialist nurses. Members of the team assess the person with Parkinson’s and identify any potential difficulties.
There are a limited number of multidisciplinary teams in Victoria that specialise in Parkinson’s management.
Surgery is an option
Neurosurgery (brain surgery) is an option to treat Parkinson’s symptoms, but it is not suitable for everyone. There are strict criteria and guidelines as to who can be a candidate for surgery and this is something that only your doctor and you can decide.
The three commonly used forms of surgery are:
Help for carers
Being a carer can be difficult. A wide range of agencies can provide help and support. These include:
Support includes counselling, carer education programs, information on a variety of issues and support groups.
Where to get help
Things to remember
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