Mathematician Chen Jingrun, writer Barkin, "boxer" Ali, Oscar actress Catherine Hepburn, what do they have in common?
A: They are all "Parkinson's disease" patients.
At the opening ceremony of the 1996 Olympic Games in Atlanta, "Boxer" Ali lit the flame of the venue with a trembling hand.
In China, 1 to 2 Parkinson's patients out of 100 middle-aged and elderly people. If Parkinson's disease is a puzzle, what is each piece of the puzzle?
World Parkinson's Disease Day is celebrated annually on 11 April. Life Times (search for "LT0385" within WeChat to follow) interviews authoritative experts to teach you to identify the early symptoms of Parkinson's disease.
Experts interviewed
Wang Han, chief physician of the Department of Neurology, Peking Union Medical College Hospital
Half of the world's Parkinson's disease patients are in China
According to the World Parkinson's Association, there are 5.7 million Parkinson's patients worldwide, and about 2.7 million to 3 million patients on the mainland, and it is growing at a rate of nearly 100,000 per year.
Parkinson's disease is a common neurodegenerative disease, also known as tremor paralysis, that occurs more often in middle-aged and elderly people over the age of 50.
In 1817, the English physician James Parkinson was the first to systematically describe the disease.
To this day, the cause of its onset is still unclear, and it is currently believed to be mainly related to genetic inheritance, environmental problems (such as pesticides, decoration pollution, etc.), aging and other factors.
A number of studies have found that when the "substantia nigra" of the human brain loses dopamine or dopaminergic neurons, it will suffer from Parkinson's disease.
Parkinson's disease is a often misdiagnosed disease with strong camouflage ability, and there is a long prodrome (up to 10 years) before typical symptoms such as tremor, slowness of movement, and muscle stiffness appear.
The data show that after the relevant symptoms of Parkinson's disease in mainland China, the average time of treatment is delayed by more than half a year, and nearly half of the patients can be diagnosed for more than one year.
Parkinson's disease has a symptom "puzzle"
If Parkinson's disease is likened to a puzzle, and each symptom is equivalent to a small piece of the puzzle, then the puzzle has changed from a few pieces to dozens.
Motor symptoms
At present, motor symptoms are still the main threshold for diagnosing Parkinson's disease, and it is also a symptom that Parkinson's patients must have, which are specifically manifested as trembling, stiffness, slowness and other aspects:
1
Shake – like rubbing pills
Tremor, or "resting tremor".
In general, hand shaking is the first symptom of Parkinson's disease, but not all patients must have this feature. Some patients have only a stiffness in the limbs, no tremors, and are called non-tremor Parkinson's.
Parkinson's patients' hands are shaking, and there is a special name for "pill-like action", that is, when the thumb and the flexed index finger are shaken, it is like rubbing a pill.
Pill-like action
Appears or is evident at rest, can be temporarily controlled by consciousness but not lasting;
Stop or alleviate during exercise;
Worsening in cases of fatigue, agitation, nervousness or anxiety;
Disappears after falling asleep.
Tremor usually begins at the distal end of one upper limb and gradually extends to the ipsilateral lower limb and contralateral upper and lower limbs. The jaw, lips, tongue, and head can be affected at a frequency of 4 to 6 times per second.
2
Stiffness – like wearing a mask
Stiffness, or "muscle stiffness," refers to muscles that become tense and feel stiff and inflexible when moving.
Parkinson's disease can significantly reduce a person's facial expression, the number of blinks is reduced, and the expression is dull, like wearing a mask, medically known as a "mask face", which is often misdiagnosed as depression.
3
Slowly– the feet seem to be glued to the ground
"Slow movement" is the most critical manifestation of motor symptoms, including walking small steps, slow speech, and smaller writing; patients feel inflexible when brushing teeth, beating eggs, rolling dumpling skins and other fine movements.
When a normal person walks, his arms swing randomly and symmetrically. When Parkinson's patients walk, their arms do not swing freely, and one foot seems to be glued to the ground, and the height of the foot is inconsistent.
In the early stages, these motor symptoms may be mild, but suggest that the onset of the disease may have begun.
Non-motor symptoms
Non-motor symptoms, which begin to appear 5, 10, or even 20 years before the onset of motor symptoms, mainly include olfactory loss, sleep disorders (including intermittent sleep and difficulty falling asleep, or shouting at night), constipation, cognitive impairment, depression, etc.
Concordia doctors recommend 6 self-tests of movements
Wang Han, chief physician of the Department of Neurology at Peking Union Medical College Hospital, suggested that if Parkinson's disease is suspected, a self-test can be performed through the following actions:
Action One
In a quiet state, the hands are naturally placed on the legs or table top to see if the hands tremble involuntarily, such as rubbing pills.
Action two
During walking, check whether it is difficult to start, whether the two-step posture is clumsy, and there are heavy steps on one side, dragging steps, etc.; or there is a situation where the steps cannot be stopped.
Action Three
Raise one hand, palm fully extended, clench your fist, repeat 10 times and gradually speed up, then change to the other hand.
Observe for uncoordinated or asymmetrical movements of the two hands.
Action Four
Raise a hand, above the shoulder, with the index finger and thumb open, repeatedly and quickly pinch and extend, repeat 10 times and gradually accelerate, whether there is uncoordinated movement of the two hands, or the fingers can not be fully expanded.
Action Five
Straighten your arms and hands, do the action of flipping the back of your palms, and gradually speed up to see if there is a pause or decrease in amplitude of the two-handed movement.
Action Six
On the ground, lift one side of the toe, repeat the tiptoe action, 10 times between the left and right feet, and observe whether there is a trend of pause and smaller amplitude.
If one of the above actions is a positive answer, you should be wary of Parkinson's disease, especially people over 50 years old, and should go to the neurology department for screening as soon as possible.
Parkinson's disease cannot be cured at present, but most patients can return to normal life through drug treatment, surgical treatment, rehabilitation exercises, lifestyle adjustments, etc.
Give Parkinson's patients a sweet home
At present, the specific cause of Parkinson's disease is unknown, and it is difficult to prevent it effectively. Complications can only be prevented as much as possible after the onset of the disease.
Due to the decline in smell and the less sensitive body response than ordinary people, the annual fall rate of Parkinson's patients is as high as 50% to 68%, and another 7% of Parkinson's patients will have hip fractures within 10 years after the onset of the disease.
A safe and comfortable home environment is very important for Parkinson's patients:
In the bedroom
1. The bed should be close to the wall, and the height should be better than the foot can land on the ground after sitting down, so that it is more convenient to go to bed and get up;
2. If you feel thirsty at night, you can put a glass of water on the bedside table, but to prevent spilling;
3. Try not to carpet, create a safe floor to walk on, and reduce falls.
In the kitchen
1. If the patient cannot hold the cup with hand tremor, a straw should be prepared;
2. Fix the dishes with non-slip mats to make eating safer;
3. If the eating speed is relatively slow, you can use thermos cup and bowl to maintain the temperature of the food.
toilet
1. It is best to lay anti-slip mats on the bathroom floor and in the bathtub to avoid falling;
2. It is best to sit in the shower, or sit in the bathtub to wash;
3. Automatic faucets can be installed in the bathroom, which can be opened or closed with a simple touch;
4. Parkinson's disease will reduce the patient's sensitivity to heat, for safety reasons, the water heater temperature should be set at about 38.8 ° C.
Coat cabinet
1. Try to choose clothes that are easy to wear and take off or open in front, clothes with zippers are the best, you can add a small ring or small rope to the chain buckle, which is easy to pull;
2. Try to use shoes that do not need to tie laces, such as zippered shoes;
3. Sit on a comfortable stool when wearing shoes, and the height of the stool is based on the standard that the feet can land on the ground;
4. When it is not convenient to dry the body with a towel, you can prepare a bathrobe with better water absorption in the bathroom.
In addition to the living environment, Parkinson's patients also pay attention to diet and daily exercise:
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Diet: Eat less meat and eggs, eat more melon beans
People with Parkinson's disease may have difficulty swallowing, insufficient food, malnutrition or osteoporosis, and even stool obstruction due to long-term constipation.
It is recommended to increase the grains appropriately and eat vegetables and fruits every day. Eat about 6 or more vegetables or melons, pay attention to less oil, it is best to boil vegetables. Appropriately increase the intake of milk (drinking two cups of skim milk per day) and soy products.
Exercise: Drumming the cheeks and blowing the whistle to prevent "mask faces"
1. Facial muscle exercise: frowning in the mirror, forcefully opening and closing the eyes, pouting, mouthing, tongue and cheek bulging and other expressions help to alleviate the "mask face".
2. Exercise both hands: often straighten the palms, use one hand to grasp the fingers of the other hand and apply pressure in the direction of the back of the hand to prevent joint deformities; you can also repeatedly practice the movement of separating, merging and clenching fingers.
3. Balance ability training: when sitting, kneeling and standing, the center of gravity is moved forward, backward, left and right, and sideways.
4. Language barrier training: Insist on practicing the tongue repeatedly sticking out and retracting, moving left and right. In addition, reading and singing can exercise lung capacity and improve the phenomenon of insufficient speech.
Parkinson's disease itself is not a fatal disease and generally does not affect life expectancy, but has a greater impact on quality of life.
Please give Parkinson's patients a little more patience and a little more warm companionship. Look forward to medical progress, early overcome the difficulties of Parkinson's disease, so that life away from trembling. ▲
Editor of this issue: Zheng Ronghua
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