Do you also have tremors and slow movements? Let's talk about Parkinsonism!

Do you or someone you know have symptoms like walking a little slower, shaking hands, or a stiff body? You may have heard the word "Parkinsonism" when you talked to a doctor about this. So, what is Parkinsonism? Let's talk about it simply, in a way that you can understand. Don't be afraid, it's very important to know all this.

What is Parkinsonism? Simply put...

Think about it, Parkinsonism is not a single disease, but a general name for several diseases. In all of these diseases, some parts of our brain are affected. The main things that happen are slow movements, stiffness (rigidity) in the body, and tremors. There can be a variety of reasons for these conditions. Some of them are genetic mutations, reactions to certain medications, or even some infections.

What is the difference between Parkinson's disease and Parkinsonism?

This is something that confuses many people. Parkinson's disease is one of the diseases within the broad category called Parkinsonism. In fact, about 80% of people with Parkinsonism actually have Parkinson's disease. That means it is the most common disease in this category.

Apart from this, there are other diseases that fall under the umbrella of Parkinsonism. Examples include conditions like ``Multiple System Atrophy`` or ``Corticobasal Degeneration``.

The important thing is that some Parkinsonism conditions are caused by treatable, and sometimes curable, causes. Also, some causes may resolve on their own, and only the symptoms need to be treated.

Who is affected the most by this situation?

Parkinsonism is generally a disease associated with aging. That is, it is most common after the age of 60. Men are slightly more likely to develop the condition than women.

However, sometimes these conditions can occur at a much younger age. For example, there is a condition called ``Juvenile Parkinsonism`` . It usually begins around the age of 17. This type of Parkinsonism is about four times more common in boys than in girls. Imagine how difficult it is for some children to get this condition.

How common is this condition?

Parkinson's disease, the most common form of Parkinsonism, is the second most common age-related neurodegenerative disease (after Alzheimer's disease). It is also the most common movement-related brain disease. Experts estimate that at least 1% of people over the age of 60 worldwide have the disease.

How does this condition affect your body?

The effects of Parkinsonism on the body depend on the cause. Most Parkinsonism conditions affect the parts of the brain that control movement. This means your movements become slower . You may also experience muscle tremors , which can make you shake.

What are the main symptoms of Parkinsonism?

There are three main symptoms of Parkinsonism:

• Slowness of movement (`Bradykinesia`) : This is a characteristic that is definitely seen in all Parkinsonism cases. Simply put, it is a feeling of slowness and difficulty when starting to do something, walking, or performing daily tasks.
• Tremors : Shaking of the hands, legs, and sometimes even the jaw, even when standing still. This shaking is usually worse when you are at rest and may decrease slightly when you are doing something.
• Rigidity : Muscles in the limbs, neck, and other areas become stiff and difficult to bend or straighten. Movements may be stiff, like a robot.

In addition to these main symptoms, other symptoms may include:

• Unstable posture or walking pattern : Feeling as if you are losing your balance while walking, falling easily.
• Forward-leaning, hunched posture : When standing or walking, there is a tendency to lean forward and hunch back.
• "Freezing" : When you start walking, try to go through a narrow space like a door, or try to turn, your legs suddenly get stuck and you feel like you can't take a single step forward.

Symptoms associated with specific Parkinsonism conditions

Some types of Parkinsonism have specific symptoms. Let's take a look at what they are:

• Parkinson's disease : In addition to the aforementioned motor symptoms, other symptoms related to processes that occur in the body without our awareness (non-motor symptoms) may also occur. For example:
• Constipation
• Loss or decreased sense of smell
• Sleep problems (such as screaming in your sleep, shaking your arms and legs)
• Depression
• Anxiety
• Vascular parkinsonism : This condition is caused by reduced blood flow to the brain. It causes problems with walking and balance from an early age . It can also cause difficulty speaking (dysarthria) and difficulty swallowing (dysphagia). Some people may also experience an abnormal upward response (Babinski's sign) in which the toes are extended when the sole of the foot is touched in a certain way.
• Drug-induced parkinsonism : This condition can be caused by certain medications (especially some medications for mental illness). In this condition , symptoms can affect both sides of the body equally . In Parkinson's disease, symptoms usually affect one side more than the other.
• Toxin-induced parkinsonism : This condition can be caused by exposure to certain toxins (e.g., pesticides, industrial chemicals). People with this condition have increased stiffness in their movements (`(cogwheel rigidity)`) . That is, they move in jerky, jerky movements, like the second hand of a clock. Muscles become stiff, movements become slow, and walking backwards is difficult.
• Juvenile parkinsonism : If someone under the age of 45 develops symptoms of Parkinsonism, this is considered only after other causes have been ruled out, as this is somewhat rare.

What are the reasons for this situation?

The cause of Parkinsonism varies depending on its subtype.

Parkinson's disease

When our brains are functioning normally, brain cells (neurons) use chemicals called neurotransmitters to communicate with each other. Dopamine is one such important neurotransmitter.

People with Parkinson's disease have a reduced amount of dopamine in their brains. When the brain sends signals to our muscles to move, dopamine is essential for the fine control of those movements. When dopamine is lost, those cells cannot function properly. That's why Parkinson's disease causes slow movements and tremors.

As dopamine levels decrease, a key area of ​​the brain called the basal ganglia gradually weakens. Then, the abilities controlled by that area are lost. As Parkinson's disease progresses, symptoms become more severe and more intense. In the later stages of the disease, it can affect brain function, leading to dementia-like symptoms and depression.

• Genetic Parkinson's disease : The only confirmed cause of Parkinson's disease is a genetic mutation inherited from parents. About 10% of all Parkinson's patients have this genetic cause.
• Idiopathic Parkinson's disease : If there is no genetic cause, experts classify it as "idiopathic." This means that the exact cause is unknown. Scientists suspect that it is caused by a problem with the way the body uses a protein called alpha-synuclein . Proteins are chemical molecules that have a specific shape. When some proteins misfold (called protein misfolding), the body can't use them or break them down. These proteins then build up in places, especially inside cells that use dopamine, which controls movement. When you look at them under a microscope, you can see that the proteins are clumped together.

Secondary parkinsonism

This is when Parkinsonism occurs as a result of another medical condition. Examples:

• Vascular parkinsonism : When blood flow to certain areas of the brain is reduced, those areas are damaged and symptoms of Parkinsonism appear.
• Post-traumatic parkinsonism : This is caused by brain damage from repeated head injuries. This risk is especially high in people who play sports such as boxing, rugby, and football.
• Drug-induced parkinsonism : This condition can occur if certain medications (prescribed by a doctor or narcotics) interfere with the way the body makes or uses dopamine.
• Toxin-induced parkinsonism : Toxins can destroy specific types of brain cells. If the cells that are destroyed are dopamine-sensitive cells in the basal ganglia, symptoms of Parkinsonism can occur.
• Normal-pressure hydrocephalus (NPH) : This is when excess cerebrospinal fluid (CSF) builds up inside the skull, putting pressure on parts of the brain involved in walking and urinary control. This can be caused by a variety of things, including injuries, brain hemorrhages, and tumors. It is called NPH because a lumbar puncture (a procedure that looks at the pressure in the spinal cord) shows areas of fluid in the brain, even though the pressure is normal.
• Postencephalitic parkinsonism : Encephalitis is swelling of the brain caused by an infection. Parkinsonism can occur after such an infection has healed. This condition is now very rare in developed countries.

Atypical parkinsonism

These are uncommon or rare conditions that cause Parkinsonism:

• ``Progressive supranuclear palsy''
• `Corticobasal degeneration`
• `Multiple system atrophy`

Other types of dementia or hereditary conditions

Parkinsonism can also be caused by other degenerative brain diseases and genetic conditions. Some examples include:

• Alzheimer's disease
• Huntington's disease
• Wilson's disease

Is this contagious?

No, Parkinsonism is not a contagious disease. However, some of the genetic conditions that cause it can be inherited from parents to children.

How is Parkinsonism diagnosed?

When diagnosing Parkinsonism, it is very important for a doctor to examine your symptoms, ask you questions, and review your medical history .

If doctors can't find a specific cause for your Parkinsonism, they will try to start treatment right away. If you don't respond to treatment, doctors may do more tests. If you don't respond to treatment for Parkinson's disease, they may think you have a different type of Parkinsonism.

What tests are done to diagnose this condition?

When doctors suspect a condition that falls under the category of Parkinsonism, they may perform various scans and diagnostic tests. These include:

• Blood tests : These can help identify other types of Parkinsonism.
• CT scan (`CT scan` - Computerized Tomography scan)
• Genetic testing
• MRI Scan (MRI - Magnetic Resonance Imaging)
• PET scan (`PET scan` - Positron Emission Tomography scan)

New tests are coming! There are new lab tests that are currently being tested, but not yet approved. These may help diagnose conditions like Parkinson's disease. These tests look for a protein called alpha-synuclein in your cerebrospinal fluid or nerves that doesn't work properly. But more research is needed before these tests can be widely used.

How is Parkinsonism treated?

Treatment for Parkinsonism depends on the condition and its cause. Most types of Parkinsonism can be treated. Some can even be stopped completely (although this may not be a complete cure, but rather a ``remission'' of the disease).

Some examples of conditions that can be treated:

• Drug-induced parkinsonism : This is usually the easiest type of parkinsonism to treat. It occurs when other medications interfere with the way the body uses dopamine. Stopping the drug that caused the parkinsonism (often by switching to a different drug) is the only way to stop the condition. However, sometimes it can take weeks or months for symptoms to completely go away. Very rarely, it can be permanent.
• Normal pressure hydrocephalus (NPH) : NPH is treated by reducing the pressure inside the skull. A shunt (small tube) is inserted to allow excess cerebrospinal fluid (CSF) to drain out of the skull. As long as the shunt is working properly, this can reduce or eliminate symptoms of Parkinsonism.
• Parkinson's disease : This condition cannot be cured, but it can be controlled to a large extent with the drug Levodopa and other medications given along with it. However, one of the disadvantages of Levodopa is that its effectiveness decreases over time. Also, if the dosage is increased beyond a certain limit, the chances of side effects are also high. However, there are many medications that can be used instead of or in addition to Levodopa that can help to overcome this problem.
• Wilson's disease : This is an inherited condition that causes excess copper to build up in the body. Treatment to remove excess copper from the body can prevent permanent damage from this condition.

Your doctor is usually the best person to tell you more about whether your condition can be treated or cured. Because there are many different conditions that fall under the umbrella of Parkinsonism, they are very different from each other. Your doctor can tell you whether your condition can be treated and what treatment options are available to you, based on your specific situation and circumstances.

How can I take care of myself and manage my symptoms?

Parkinsonism refers to a wide range of diseases and conditions that have similar effects and symptoms. Many of these diseases and conditions are severe, and the risk of complications is high if they are diagnosed and treated late.

Because many of these conditions are serious and need to be recognized and treated quickly, do not try to self-diagnose or treat the condition yourself. If you think you may have Parkinsonism, it is important to see a doctor as soon as possible. He or she can determine if you have one of these conditions, or refer you to a specialist for diagnosis and treatment.

How quickly will I feel better after treatment?

The time it takes for you to feel better and recover after treatment depends on several factors, including your condition and the treatment you receive. Your doctor is the best person to tell you what to expect about your recovery time and when you will start to feel better.

Can this situation be prevented and the risk reduced?

Parkinsonism often occurs unexpectedly, so it usually cannot be prevented or the risk of developing it reduced.

However, there are some types of secondary parkinsonism that you can reduce your risk of developing. These are:

• Toxin-induced parkinsonism : The risk of developing this type of parkinsonism can be reduced by avoiding the toxins or substances that cause it, or by using protective equipment to reduce exposure when they cannot be avoided. Think of things like wearing a mask and gloves when spraying pesticides.
• Post-traumatic parkinsonism : The risk of developing this can be reduced by using protective gear (e.g. helmets) to protect against head injuries.
• Vascular parkinsonism : To reduce your risk of developing this, you need to take care of the health of your circulatory system, especially blood flow to the brain. This includes maintaining a healthy weight, eating a balanced diet, and being physically active.

What can I expect if I have this condition?

In all cases of Parkinsonism – regardless of the specific condition – there is slowness of movement and other associated symptoms. What you can expect will depend on the specific condition you have and the treatment you receive (if any). If you have Parkinsonism, your doctor is the best person to tell you more about what you can expect.

How long does Parkinsonism last?

How long Parkinsonism lasts depends on the specific condition. Many conditions that fall under Parkinsonism are lifelong conditions. One condition that is not always a lifelong problem is `drug-induced parkinsonism`.

Because Parkinsonism includes so many different conditions, it's best to talk to your doctor about how long your condition will last. He or she can explain exactly what you can expect, including the timeline for how the condition will affect you.

What is the outlook for this situation?

The outlook for Parkinsonism depends on your condition, how severe it is, and whether it can be treated. Most types of Parkinsonism are not directly fatal, but they can contribute to complications that can be fatal. For example, difficulty swallowing, a common symptom of Parkinson's disease and other types of Parkinsonism, increases the risk of developing a condition such as pneumonia.

How can I take care of myself?

If you have Parkinson's, it's important to follow your doctor's instructions for caring for you and managing your condition. He or she is the best source of information about how your specific condition affects you and what you can do to help yourself.

Typically, you should do these things:

• Take your medications exactly as prescribed. If your doctor has prescribed medications, taking them exactly as prescribed can make a big difference in the symptoms of Parkinsonism. You should talk to your doctor if you experience side effects or if you feel like your medications are not as effective as they used to be.
• See your doctor as recommended. Your doctor will schedule appointments for you. These appointments are especially important to help manage your condition, find the right medication and dosage, and minimize any side effects.
• Don't ignore or ignore symptoms. Parkinsonism can cause a variety of symptoms. Many of them can be treated by treating the underlying condition or the symptoms themselves. It's important to tell your doctor about any symptoms, even if they're minor. Many Parkinsonism conditions can be easily confused with each other. So telling your doctor about all of your symptoms can sometimes help avoid a misdiagnosis.

When should I see a doctor?

You should see a doctor if you notice a change in your symptoms (especially if the symptoms start to interfere with your life and daily activities) or if you notice a change in the effectiveness of your medication.

When should I go to an emergency room (ER)?

Your doctor can give you guidance and information about signs and symptoms of whether you should go to the hospital or seek medical advice. In general, you should seek medical advice if you fall, especially if you lose consciousness, or if you think you may have injured your head, neck, chest, back, or abdomen.

Finally, things to remember

Parkinsonism is a general term for a wide range of conditions that affect your ability to move and live independently. While there are some similarities between all of these conditions, they can also be very different. If you are diagnosed with Parkinsonism, it is important to talk to your doctor about what condition you have (or what doctors suspect) and how the diagnosis will affect you. Not all Parkinsonism is the same. So understanding your specific condition can make a big difference in managing it and how it affects your life.

` Parkinsonism, Parkinson's disease, tremors, slowness of movement, brain diseases, neurological diseases, dopamine