Is Parkinson's a patent for the elderly?

Speaking of Parkinson's disease, it is often considered as senile disease, but Parkinson's disease is not a patent for the elderly, and it is not uncommon for young and middle-aged people under 50. According to statistics, the proportion of Parkinson's disease among young and middle-aged people exceeds 10%, which is more than 200,000 in China. Young and middle-aged patients with Parkinson's disease are often the pillars of their families, with old people in the world and young people in the world. The long-term illness has brought a heavy burden to the family and society. Patients want to work with illness, so that they can go to the hospital in a hurry, which should attract enough attention from the whole society.

Compared with Parkinson's disease in the elderly, Parkinson's disease in young and middle-aged people is relatively rare, and its incidence is relatively hidden, which is easy to be misdiagnosed. However, there are many cases with family history. Usually, they first show a feeling of static tremor or stiffness of one limb, and when they walk, their symptoms gradually get worse. A few years later, the symptoms developed to another limb. Doctors can find that when walking, muscle tension increases and the swing amplitude of upper limbs decreases. In the middle and late stage, there may be four symptoms: tremor, stiffness, bradykinesia and abnormal posture, so the diagnosis is relatively easy.

The treatment of Parkinson's disease varies with age. The drug selection, dosage and surgical treatment cycle of Parkinson's disease in young and middle-aged people are different from those in old Parkinson's disease. In the early stage of Parkinson's disease in young and middle-aged people, if the symptoms are not serious or obvious and do not affect their work and life, they can be clinically observed and not treated or applied with nerve cell nutrition drugs for the time being. If work and life are affected to some extent, they should take medicine, but they are different from the elderly in drug selection. Dopamine receptor agonists, monoamine oxidase inhibitors, amantadine and other drugs should be selected, and levodopa preparations should be avoided as far as possible. Although the therapeutic effect of levodopa preparation is good, we know that the life span of middle-aged and young people with Parkinson's disease is still very long, and the most effective honeymoon period of levodopa preparation is only about 5 years. After the honeymoon period, the dosage will increase, the curative effect will decrease, and there will be symptoms of trembling and dancing all over the body, the switch phenomenon of drug effect coming and going, and other side effects of dyskinesia. When the symptoms are obvious in the middle and late stage, we should use drugs reasonably, but we should also master the principle of "small water flows over a long period of time, and observe the principle of dose titration". On the premise of improving life ability to the maximum and minimizing side effects, the lower the maintenance amount of levodopa, the better. The treatment of Parkinson's disease with brain pacemaker is relatively mature. At present, the latest view is that the treatment period of brain pacemaker for Parkinson's disease should not be too late. If the effect of drug treatment decreases after honeymoon and side effects appear, brain pacemaker surgery should be considered, not after losing work. Functional exercise is also a prerequisite to ensure the maximization of drugs and surgical treatment from beginning to end.