Parkinson = Paralysis agitans = Schüttellähmung oder Zitterlähmung
* Rigor (Muskelstarre),
* Bradykinese (verlangsamte Bewegungen) kann bis zu Bewegungslosigkeit führen kann,
* Tremor (Muskelzittern) sowie
* posturale Instabilität (Haltungsinstabilität).
Verlangsamung der geistigen Prozesse (Bradyphrenie).
Typisch für Parkinson sind neben dem Zittern auch Muskelsteifheit, verlangsamte Bewegungen, Gang- und Gleichgewichtsstörungen. Die Muskeln gehorchen nicht mehr richtig. Wenn ein Zittern durch Parkinson hervorgerufen wird, erkennt man das daran, dass die Hand in Ruhe zittert und nicht bei Bewegungen. Betroffenen können problemlos eine Tasse Kaffee zum Mund führen, nicht aber die Hand ruhig auf dem Tisch halten.
„Parkinson entsteht, wenn im Gehirn Nervenzellen absterben, die den Botenstoff Dopamin herstellen“, so PD Dr. Ebersbach. Dopamin ist für die Steuerung und Feinabstimmung der Bewegungen absolut notwendig. Warum es zum Absterben der Zellen kommt, ist unklar. „Wahrscheinlich spielen erbliche Veranlagung und Umwelteinflüsse eine Rolle.“
Diagnose: Den wichtigsten Hinweis bringt ein Test
Machen sich Parkinson-Symptome bemerkbar, sollte jeder Patient zum Neurologen. Der kann die Symptome am besten beurteilen und sie von anderen Erkrankungen unterscheiden. Einen wichtigen Hinweis bietet ein Test: „Die Patienten erhalten versuchsweise das Parkinson-Medikament L-Dopa“, erklärt Neurochirurg Dr. Thomas Reithmeier vom Städtischen Klinikum München-Schwabing.
„Bei Parkinson bessern sich die Symptome. Tun sie es nicht, hat man höchstwahrscheinlich keinen Parkinson.
Die Erkrankung beginnt meist zwischen dem 50. und 60. Lebensjahr (Gipfel 58. - 62. Lebensjahr). Tritt selten bereits vor dem 40. Lebensjahr auf.
Dopaminmangel/Botenstoff Glutamat liegt dabei relativ im Überschuss vor.
mögliche Beteiligung von Melatonin an den neurodegenerativen Prozessen der Parkinson-Krankheit.
Ursachen: neurotoxische Umweltgifte [Pestiziden/Trichlorethylen (Parkinson/langsamere Feinmotorik)]
Beginnt schleichend (einseitig/Frühzeichen: z.B. reduziertes/später fehlende Mitschwingen eines Armes laufend/Schulterschmerz und einseitige Muskelverspannungen)
Das Parkinson-Syndrom ist definiert durch das Vorliegen von Brady- bzw. Akinese und eines der drei anderen Leitsymptome (Rigor, Tremor, posturale Instabilität).
Akinese [auch Bradykinese (Verlangsamung der Denkabläufe) o. Hypokinese]
Diese allgemeine Bewegungsarmut ist Voraussetzung für die Diagnose eines Parkinson-Syndroms. Sie macht sich bei allen Bewegungen bemerkbar. So vermindert sich das Muskelspiel (Maskengesicht/Hypomimie)/Sprechen wird leise/undeutlich/Schlucken verzögert/Geschicklichkeit der Hände lässt besonders bei schnellen Bewegungen nach (Schriftbild wird kleiner)/die Rumpfbewegungen sind erschwert (vermindertes Umlagern im Schlaf)/Gangbild wird kleinschrittig und schlurfend
+ Rigor (steife Muskeln/gebeugte Ellenbogengelenk, Rumpf und Nacken/Kniegelenke.
+ Ruhetremor (langsames Zittern abnehmend bei Bewegung/einseitig betont).
+ Posturale Instabilität (kleinen, aber schnellen reflektorischen Ausgleichsbewegungen werden verzögert, so dass es zur Gang- und Standunsicherheit kommt/Wendebewegung wird unsicher/Trippeln/
Angst zu fallen)
+ Fakultative Begleitsymptome
Sensible Symptome (Minderung des Geruchssinns häufig/oft ein initiales Symptom)/Missempfindungen (Dysästhesien)/Schmerzen treten an Gelenken und Muskeln
Vegetative Störungen: Fett-glänzende Gesichtshaut entsteht durch gesteigerte Talgproduktion (zusammen mit der Hypomimie).
Im fortgeschrittenen Krankheitsstadium Kreislaufregulationsstörungen (orthostatische Hypotonie).
Blasenfunktionsstörungen behindern die Patienten im sozialen Leben erheblich. Meist steht zu Beginn ein plötzlicher starker Harndrang, oft schon bei kleinen Füllmengen (Pollakisurie).
Sexualfunktionsstörungen sind häufig und betreffen sowohl die Libido als auch die Potenz.
Durchfall als auch Verstopfung./Durchfall führt zu einer Unterdosierung, weil mehr von den verabreichten Wirkstoffen als pharmakologisch kalkuliert vorzeitig unresorbiert den Körper verlassen. Verstopfung führt zur Überdosierung, weil mehr von den verabreichten Wirkstoffen als pharmakologisch kalkuliert im Körper verbleiben und resorbiert werden.
Temperaturregulationsstörungen führen vor allem zu einer verminderten Hitzetoleranz durch eine Störung des reflektorischen Schwitzens und der reflektorischen Gefäßerweiterung bei Wärme. (in fortgeschrittener Erkrankung zu lebensbedrohlichen hochfieberhaften Zuständen führen/nachts SchweißAUSbrüchen.
Eine niedergedrückte Stimmung kann als Frühsymptom der Diagnose um Jahre vorausgehen. Sie betrifft im Verlauf mindestens 40 Prozent der Patienten.
Verlangsamung der Denkabläufe ist Ausdruck der allgemeinen Antriebsstörung/nur Denken verlangsamt, nicht aber inhaltlich beeinträchtigt. Einschätzung von Entfernungen und Geschwindigkeiten gestört. Nebenwirkung von dopaminergen Medikamente. Sinnestäuschungen/= gutartigen Halluzinationen, die der Betroffene als Trugbild erkennt. Zum Beispiel werden nicht vorhandene Personen
im Raum gesehen. Die psychischen Veränderungen sind für die Alltagsbehinderung der Parkinson-Patienten von erheblicher Bedeutung und werden oft unterschätzt, da sie nicht so augenfällig sind
wie die motorischen Phänomene.
REM-Schlafstörungen werden oft berichtet und können anderen Parkinson-Symptomen vorausgehen.
Häufig existiert eine Assoziation mit Symptomen des Restless-Legs-Syndroms.
The main scope of homoeopathic drugs in Parkinsonism are to delay the progress of the disease and to keep the dosage of dopamine agonistic drugs to the minimum.
I had to resort many times to small unproven remedies to support the patient.
A known case of Parkinsonism which I have been treating for 18 months with Nux vomica was not getting better beyond a certain point, I was not successful in getting his dose of Levodopa reduced with homoeopathy, whenever I tried to reduce the dose the Parkinsonism was getting worse and hence I wanted to prescribe another remedy.
He was 65 years old, short, stout he had a history of stroke when he was 59 years old, he was then admitted in the hospital and later on he was discharged with almost 90% recovery.
He is a very angry man by nature. He can become violent when he becomes angry, smallest mistake on part of anybody can make him angry. He complained of constant heaviness in the head;
the speech was not very clear, it was on the heavier side. He complained of having severe cramps in thighs and legs < exertion and during sleep. There used to be tightness as if rope is tied in the calves’ muscles.
The gait was slow and typical shuffling. There was trembling of fingers, hands and legs. Trembling < with emotional excitement. It was difficult for him to hold the pencil or a pen and he could not even also hold the glass of water, drinking water will always spoil his clothes.
He was severely prostrated even without any exertion, but when lying down and resting he would be restless.
Extremities were cold; with this symptomatology I prescribed him a rare remedy: Lolium. temulentum 30th C and stopped Nux-vomica continued the medicine for a period of 6 to 8 months,
I could give him a very good relief with practically 70 to 80% reduction of his Levodopa. Since then this remedy is being very useful for me in Parkinsonism.
Most of the symptomatology of this remedy comes from the poisonous property of the grains which are present on the grass. The grains are nothing but the common ergot, known as Claviceps purpurea.
Other than Parkinsonism I use this remedy for writer’s cramp. This remedy closely resembles Nux vomica in pathophysiology. The patient is extremely chilly; there is marked state of over sensitiveness from squeaking of the door, scratching on the glass, moving of the furniture. There is marked awkwardness (drops the things) and trembling of the hands (cannot hold the spoon, and cannot write).
Another case which I would like to describe is a case of a Bengali gentleman aged 73 years, he was staying all alone in Mumbai, he had his family in Calcutta but slowly over a period of years everybody in his family gradually died. He was a bachelor, his profession was of a music teacher, and he never made much money out of his profession but was quite contented and satisfied.
He was very strong willed but over a period of year because of his chronic Parkinsonism he started becoming dependant on people much against his wish. He had some saving from which he used to live his life on a day to day basis.
I probed more into the details of his past, He mentioned that his childhood was not so happy in Calcutta; he used to suffer from convulsions due to worms. Recurrent hepatitis was another illness he faced as a child this lead to frequent absenteeism from the school, He did his graduation and later on he showed his interest towards music and started learning music. He got some opportunity to learn music in Mumbai and that is the reason why he left Calcutta and came to Mumbai. Through out his life he was quite alone and lonely, initially when he was young loneliness never used to affect him but late on after the age of 45 the loneliness was his biggest enemy.
His childhood was not very happy at all, he had faced lot of violence from his father and he himself became a victim also of his father’s violence. Father was a quite authoritative figure in his life. By the time he joined the college he developed a strong hatred and disappointment because he could not receive the love and affection from his father, this made him very jealous and envious about other children who used to get lot of love from their family.
Another very important aspect which he mentioned was disappointment in love. He was in love with a Bengali woman and he was about to propose to that woman and he came to know that this woman was not of a good character and this was one of the biggest grief of his life, he still cannot forget this incidence because he regrets of not being able to judge that woman.
He also mentioned that he does not like to be contradicted; this makes him very angry. He had a fear of dogs, high places and allopathic medicines; he always felt that allopathic medicine is like a poison.
The Parkinsonism disease was diagnosed when he was 54 years old but he comes to see me only when he is 73 years old. He tried lot of homoeopathy but ultimately he had to take the help of allopathic medicines much against his wish. After taking 9 years of taking allopathic medicines somebody recommended my name and he came to me. Of course I only assured him that I can reduce the dose of Levodopa to minimum and give him some relief in his tremors and rigidity which were his main complaint.
While giving the history I observed that he was constantly frowning but he was quite jovial in nature. I also found him intellectual because he could discuss many subjects in which he was not at all qualified to talk. He said these days his memory has become quite weak he will forget what has read or he will forgets easily what he has said.
He is quite religious and spiritually inclined. People who lived in his building used to call him little loquacious individual because he was all alone and he loved to talk with people, he was quite lively and elegant but there were occasions where he can even sit silent for hours together especially when nobody is around to talk.
[Dr. Farokh Master]
Parkinsonism in simple words is defined as a gradual deterioration of nerve centres in brain, responsible for controlling movement; as degeneration proceeds, the delicate balance between Dopamine and Acetylcholine that ensures transmission of nerve impulses is also upset.
In most cases no obvious cause can be found, but in a few cases the culprit has been found to be carbon-monoxide poisoning, poisoning by heavy metals such as mercury or manganese, or drugs particularly phenothiazines used in the treatment of schizophrenia.
In allopathic science, Parkinsonism is usually controlled by anti-cholinergic drugs, but these can have unpleasant side effects. The following remedies have been useful to at least help the patient to stabilize their dose of anti-cholinergic drugs or to reduce their intensity of tremors or help in their rigidity or stiffness –
a) Neodynium metallicum 30 C has shown excellent results to gradually keep the tremor and rigidity under control.
b) Lolium 30 C has been found very effective in controlling the tremors.
c) Hyoscyamine hydrobrom 30 C has been effective in controlling rigidity and depression that frequently accompanies the disease.
James Parkinson, 1755 – 1824 was a general practitioner in London and during his medical work he saw six patients with a new disease. He described this condition as the "Shaking Palsy"
and also proposed a Latin synonym "Paralysis Agitans".
Parkinson's description of this condition has become a medical classic and the definition as it appeared in his essay is as follows:
"Involuntary tremulous motion, with lessened muscular power, in parts, not in action and even when supported; with propensity to bend the trunk forward, and to pass from a walking to a running pace;
the senses and intellects being uninjured." His description of the shaking palsy was accurate and captured the essence of the disease. Therefore, the famous French neurologist Charcot proposed that the shaking palsy be called Parkinson's disease after him.
Among the common neurological diseases known to science, Parkinson's disease is one of the most common conditions.
Parkinson's disease is a disease of late middle age and beyond. It is rare before the age of 30. Thereafter, the incidence rises with increasing age. Most patients develop the disease between the ages of
50 - 79 years. When a patient develops Parkinson's disease between the ages of 20 - 40, it is called “Young Onset Parkinson's Disease" or YOPD.
An occasional patient may develop Parkinson's diseasebefore the age of 20 years called 'Juvenile Parkinson's Disease'. Both males and females are at an equal risk of being affected.
Research has shown that Parkinson's disease is not an inherited condition and multiple members having the same disease may be a chance occurrence as this is a common neurological disease. But in some families there may be a clustering of Parkinson's disease which may be more than a chance occurrence and therefore the role of inheritance is under scrutiny.
Recently environmental toxins have been implicated in the cause of this disease. There are many reasons to believe in this direction.
a) In Canada rural living, well water drinking and use of pesticides was shown to be a common feature among the patients of Parkinson's disease.
b) Recently a toxin called MPTP (1-methyl-4-fenyl-1,2,3,6-tetrahydropyridine) was discovered accidentally which was shown to have caused Parkinson's disease in a group of drug addicts in the USA. This toxin was a contaminant. Discovery of MPTP has opened up new avenues in Parkinson's disease research because we now have a potent chemical which can produce a disease like Parkinson's disease in animals thus helping scientists conduct animal experiments which were not possible till the mid-eighties.
According to prospectively collected information, there is no association between head injury and Parkinson's disease as was previously believed.
Repeated injury to the head can cause Parkinson's disease like symptoms.
This is called - drunk syndrome and has been observed in a few professional boxers.
Although stress has been proposed as a cause from the 19th century, the relation between stress and Parkinson's disease remains to be proven. The theory most widely accepted is that early in life, perhaps even before birth, a brief viral infection like encephalitisor influenza-A, enters the brain and kills a large percentage of the dopamine producing cells in the brain, wounds many others and leaves some unscathed. Even in a healthy brain, cells do not reproduce after birth and actually die at a rate of 13% every decade.
After the infection is over the remaining neurons produce sufficient dopamine and no symptoms are observable. As the remaining neurons keep on dying in normal course, a stage comes when the total production of dopamine falls below the minimum required level and symptoms become visible. This theory explains why the onset and progress of the disease is so insidious and slow.
Parkinson's disease has such an insidious onset that often the family members notice the change earlier than the patient. Family members comment on the loss of spontaneous smiling (i.e. patient has a mask-like face); absence of eye blinking & slowing of activities of daily living. They notice there has been noticeable increase in the length of time it takes for the patient to get up from sitting or reclining posture and for dressing. Relatives will volunteer that the time taken for the patient to perform routine household chores has increased and the patient takes longer to finish meals.
The patient himself complains of vague aches and pains in the body & stiffness in the joints which, in a 60 to 70 year old, are often passed off as symptoms of "old age".
The commonest complaints which bring the patient to a doctor are tremors in the hands, difficulty using the affected hand for simple functions like buttoning, tying shoe laces, wearing a sari,
or applying makeup. The disease often begins on one side of the body, but usually becomes bilateral within a few months to years. Here the patient complains of dragging of one leg while walking, difficulty in wearing sandals or slippers. Gait becomes slow and shuffling. Balance becomes poor with a tendency to fall forwards or backwards for no obvious reason.
The disease has slow progress and many patients may be static for several years & can carry on with their profession without any problems. The handwriting becomes smaller (micrographia). The voice becomes softer and speech becomes monotonous. It gives the impression that the patient is whispering instead of talking aloud. The patient may have drooling of saliva from the mouth requiring repeated wiping of the lips and the mouth.
Constipation is a common problem of Parkinson's disease.
Hyoscianinum is described in “Encyclopedia of pure materia medica” by T.F. Allen. This is much more powerful than Hyoscyamus, it has majority of the neurological symptoms of Hyoscyamus in a more violent way. Using this medicine gave a good relief to the rigidity and the stiffness of the patient, subsequently this remedy became a useful remedy in cases of Parkinsonism in my practice.
What I look for in this remedy is general feeling of heaviness, stiffness and weakness internally; picking of the nose and the lips; they are very jovial individual.
Mucuna pruriens. This is not a proved remedy and used by ancient Ayurvedic physicians in India more than 4000 years ago. Is indigenous to India. I use this remedy in mother tincture, just 2 drops 3x daily in cases where I am not able to figure out the right constitutional remedy or a prolong period the need for allopathic medicines for Parkinsonism sometimes becomes unnecessary.
Nikotin. Zigaretten sind zwar ungesund. Aber geringe Mengen an Nikotin können den Abbau von Dopamin im Gehirn unterdrücken und die Nerven schützen. Doch sollte niemand deswegen rauchen.
In Studien wird gerade erprobt, ob der Einsatz von Nikotinpflastern schützen kann.
Peperoni. Untersuchungen haben gezeigt, dass der Verzehr von scharfen Nachtschattengewächsen wie Paprika, Chili oder Peperoni das Risiko, an Parkinson zu erkranken, um bis zu 30% verringern kann. Grund dafür ist die Tatsache, dass diese Gewächse geringe Mengen an Nikotin enthalten.
Koffein. Personen, die viel Kaffee oder schwarzen Tee trinken, erkranken seltener an Parkinson. Denn Koffein unterdrückt den Abbau von Nervenzellen. Frühsymptome. Wer Parkinson rechtzeitig erkennt und behandelt, kann stärkere Symptome um viele Jahre hinauszögern. Als Frühsymptom gelten Störungen des Geruchssinns, Darmstörungen und Veränderungen der Handschrift.
Antidotiert von: Chlorpr. Coff. Hyosin.
Anacardiaceae. [Claudia Thiele]
Zinc-ars. = Ars + more „active“/parkinson with great exhaustion and diminished bowel control (Shy-Drager syndrome).
Sport: Radfahren/Nordic walking
Ein für Alzheimer wirksames allopathisches Medikament lindert Parkinsonbeschwerden
Phytologie: Wirbelsäule einreiben mit frischem Saft von Oxal-a.
Dol. pruriens = fluweelboon/enthält: levodopa/toegepast in Parkinson: