What is Dementia in Parkinson’s Disease?
Dementia is a chronic or progressive brain disorder in which higher cortical functions are impaired, including memory, thinking, orientation, understanding, counting, learning ability, language and judgment. Consciousness is not darkened. Symptoms are present for at least 6 months, although a more progressive onset of dementia is possible. Long-term medication, vitamin B12 and B6 deficiencies, metabolic imbalances due to kidney and liver diseases, as well as endocrine pathology, vascular pathology, depression, infections, head injuries, alcoholism, and tumors contribute to dementia. In the diagnosis of dementia, additional symptoms, such as delirium, hallucinations, and depression, are also noted.
Causes of Dementia in Parkinson’s Disease
Etiology and pathogenesis
The etiology is associated with dopamine deficiency in the substantia nigra as a result of a degenerative or autoimmune process. Genetic forms of the disease are transmitted in both recessive and dominant types. Close to parkinsonism cases of family tremor. The cause of parkinsonism can also be the identification of susceptibility as a result of vascular disorders, taking antipsychotic drugs, anti-asthma drugs.
The incidence of the disease is 2 cases per 1000 population per year. The exposure of men and women is the same.
Symptoms of Dementia in Parkinson’s Disease
In half the cases, parkinsonism does not lead to dementia. If this happens, then along with a typical neurological clinic: hypomimia, loss of fine coordination and synkinesis, a symptom of counting coins and a gear wheel, a tremor, including the oral area, initially intensity, and then not dependent on tension, euphoria or depression joins. These additional signs indicate a possible development of dementia. In the evening, sometimes develop vascular delirium. There is a high risk of suicidal activity, which is associated not only with depression, but also with a psychological reaction to insolvency. Hypomimia patients perceived by others as emotional inadequacy, and it is hard they experienced. Amnestic violations join later; there are no focal disorders.
Diagnosis of Dementia in Parkinson’s Disease
The diagnosis is based on the primary detection of parkinsonism, which is not due to medicinal causes, depression or euphoria, and slowly increasing amnesic disorders. On the EEG, which has to be done in connection with tremor against the background of barbiturates, there are no specific violations.
It should be differentiated from other types of tremor, tic disorders, motor manifestations in organic dissociative disorder. If other types of tremor are detected anamnesticly, then tic disorders characteristic of childhood age are transient and often associated with stress. Tremor in organic dissociative disorder results from the most common traumatic brain injury, accompanied by dysphoria. Difficult is the differential diagnosis of Parkinson’s disease with corticonegral degeneration. The disease develops at the age of 55-75 years. There is a loss of the ability to subtle movements, awkwardness in one of the limbs, then rigidity and tremor in this limb, similar disorders appear in the other hand. Dyspraxia and mask-like face are usually combined with the indicated disorders. Depression in this pathology is in the nature of a reaction to its failure.
Treatment of Dementia in Parkinson’s Disease
Cyclodol, parkopan, levodopa, jumex, midantan are used in the treatment of parkinsonism.