Parkinson’s And Movement Disorder

How is Parkinson’s diagnosed?

The diagnosis of Parkinson’s disease is made based on the patient’s reported symptoms and a neurological examination. Symptoms such as tremors, rigidity, bradykinesia (slowness of movement), gait disturbances, increased saliva production, micrographia (small handwriting), and shoulder pain can raise suspicion of the disease. During the examination, the presence of muscle rigidity, reduced amplitude and frequency of movement, and specific tremors associated with Parkinson’s lead us to the diagnosis. Brain MRI, blood tests, and urine tests may also be requested to rule out other conditions that can mimic Parkinson’s disease. However, the primary diagnosis is made through a thorough examination.

Is Any Tremor In The Hands A Sign of Parkinson’s?

Tremors can have various causes. Parkinson’s disease has its specific tremor, which is typically more pronounced on one side during rest and may resemble a “pill-rolling” motion, disappearing during activity. Tremors that occur during activities like writing, eating, or holding a glass are often signs of a condition called Essential Tremor, which is a benign tremor that is actually more common in the general population than Parkinson’s disease. In addition, there are different types of tremors associated with conditions such as multiple sclerosis (MS) or stroke. Tremors can also be physiological in nature. Factors such as stress, lack of sleep, muscle fatigue, or excessive caffeine intake can trigger subtle hand tremors.

Can Advanced Parkinson’s Be Cured?

Different treatment options are possible in patients with advanced symptoms and reduced response to oral medications. Deep Brain Stimulation in properly selected patients significantly improves the patients’ quality of life and reduces the need for drugs. The method of administering the drug, which we call Intestinal Levodopa, which is the main treatment of Parkinson’s disease, directly from the intestine rather than orally, is also a very effective method in the advanced stages of the disease. Again, there are medications applied by subcutaneous injection that improve the patient’s condition within minutes. There are many treatment options to keep patients in advanced stages from breaking away from life.

What is the importance of exercise and nutrition in Parkinson’s disease?

It has been scientifically proven that Parkinson’s patients who engage in at least 30 minutes of cardio exercises daily, which elevate their heart rate to around 120 beats per minute, effectively slow down the progression of the disease. Therefore, we recommend our patients to prioritize cardio exercises such as swimming, brisk walking, and running, as well as exercises like yoga and pilates. If these are not feasible, we suggest they perform simple physical exercises at home.

Regarding nutrition, similar to many other diseases, we recommend a Mediterranean-style diet for Parkinson’s disease. We encourage patients to follow a diet that is low in saturated fats, rich in vegetables, fruits, and fiber, and low in carbohydrates while maintaining a balanced protein intake. It is important to carefully adjust meal and medication timing as a significant portion of Parkinson’s medications can interact with food.

As for the frequently asked question about fava beans, it is true that fava beans contain dopamine. However, the dopamine in fava beans cannot enter the brain without the presence of Parkinson’s medications. Since the exact amount of dopamine in each fava bean cannot be predicted, consuming fava beans without Parkinson’s medications can lead to severe poisoning and even coma. Therefore, we prohibit our Parkinson’s patients from consuming fava beans without proper awareness

For the diagnosis of movement disorders which tests should be conducted?

Blood and urine tests should be conducted for differential diagnosis. A brain MRI scan is essential and should be performed. Unnecessary tests should be avoided, and investigations aimed at determining the cause of the disease should be conducted. Individuals with a family history of movement disorders and young patients should be referred to a genetic diagnostic center. In the near future, treatments based on genetic subtypes, especially for Parkinson’s disease, may come into play. Genetic diagnosis is a simple test that can be done by providing a blood sample and should not be neglected.

Can Dystonia Be Treated?

Could Dystonia be treated?

Oral medication treatments are possible to reduce the severity of dystonia. Botulinum Toxin (BOTOX), commonly known for its cosmetic use, is also an effective treatment method for dystonia. When botox is applied to the muscles causing inappropriate contractions guided by EMG, very satisfying results can be achieved. Deep brain stimulation (DBS) is also a very good treatment option for patients who do not respond to oral medications or botox treatments.