Complaints & connections · borters.ch
The basis is not the tremor but slowness and stiffness — and movement is the second half of the treatment, not an extra.
Also known as: Parkinson’s disease
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
In a small area deep in the brain, cells that make dopamine are lost — the substance with which movements are started and measured out. Because the brain compensates for a long time, symptoms only begin once a large share of those cells is already gone. The best-known sign, tremor at rest, is absent altogether in a quarter of people; the real basis is slowness and increasing stiffness. The one-sidedness at the start is typical: a hand that no longer swings when walking, handwriting that shrinks towards the end of a line, a foot that drags. Equally important is what shows up years earlier and is almost never connected — a lost sense of smell, stubborn constipation, a voice that has grown quiet, and vividly acting out dreams in sleep. Neurology makes the diagnosis from the examination; no blood value and no scan proves it. Treatment replaces what is missing, and that often works impressively well. The second, equally weighted part of treatment is movement: endurance, balance and large, deliberately exaggerated movement patterns are the only thing that, alongside the medicines, measurably holds everyday life together.
Fluctuating alertness, elaborate visual hallucinations and acted-out dreams point to the Lewy body form. It reacts sensitively to certain sedatives — that belongs told to every doctor and every hospital.
If the effect of the medication fluctuates, if extra movements appear or if the tremor persists, deep brain stimulation comes into question. As a rule of thumb: what responds to levodopa usually responds to stimulation too — tremor even when levodopa achieves little.
The diagnosis is a matter of examination and needs experience. The earlier the name is settled, the earlier what helps can begin.
Endurance, balance, strength training, and the methods using deliberately large movements and a loud voice. It is the only thing besides the medicines that noticeably influences the course — and it works better the earlier it starts.
The effect depends on even intervals. An hour late is noticeable in daily life, and in hospital your own timetable belongs handed over explicitly.
The main medicine uses the same route of absorption as protein from food. Half an hour’s gap from the meal makes the difference between effect and no effect for some people.
It belongs to the condition, troubles many more than the stiffness does, and on top of that slows the uptake of the medicines.
Dizziness on standing is common and one of the main causes of falls. Get up slowly, drink enough, and have the medication list reviewed for it.
L-dopa replaces the missing dopamine and acts on movement — it does not stop the cells from dying. Over the years the window of effect shortens, because fewer cells can store the substance. Movement is so far the only factor that shapes the course itself.
About one person in a hundred over sixty is affected, men slightly more often. By the time the first movement signs show, some sixty to eighty percent of the dopamine cells are already lost — which is why loss of smell, constipation and vivid dreams often come years earlier.
The voice often grows quiet before the hands tremble — and those affected still hear themselves as normally loud. When relatives say "speak up", that is not an argument but a hint.
One hand, one arm, one leg — and for years that side stays the worse one. A symmetrical start points rather to something else.
Buttons, zips, brushing teeth take longer. In a quarter the tremor is missing entirely — watching only for it means missing these people.
Getting tighter and smaller towards the end of the line. An old letter beside a new one often shows it more clearly than any examination.
A lost sense of smell, stubborn constipation, a quiet voice and vigorously acting out dreams in sleep — each harmless alone, telling together.
Small steps, one arm no longer swinging, difficulty starting off and in doorways, and balance that later becomes unsteady.
Constipation, low blood pressure on standing, disturbed sleep, low mood and pain belong to it and often shape daily life more than the stiffness.
An underactive thyroid also makes people slow, stiff and without drive. It belongs excluded once, because it is treatable.
A deficiency can affect gait and thinking and becomes more common under certain treatments — so it belongs in the follow-up.
Restless legs are often confused with this condition and frequently hang on an empty iron store — a worthwhile look.
Effects on inflammation and triglycerides established; cardiovascular prevention is mixed. Watch quality and freshness.
The core of the illness: in a small area of the brain the cells that make this messenger are lost. First signs show when a large share is already missing — which is why the early warnings lie years before.
Dopamine holds this hormone back. Drugs that block dopamine — several against nausea and from psychiatry — lift it and can at the same time cause Parkinson-like complaints.
The sleep-wake rhythm is often disturbed early. Acting out dreams can precede the movement signs by years and is one of the most reliable early warnings.
Intense, demanding training is the only measure with signs of an influence on the course.
Listed values: 1 · 10 · 20 · 30 · 52 · 93 · 174 · 432 · 1010 · 1550 · 2720 · 4800 Hz