Slow movement of the elderly

Introduction After being old, due to the deterioration of all aspects of the body, the elderly will show slowness of action, and most people are normal, not too worried. But for the elderly, it is also necessary to be alert to the early performance of Parkinson's disease. Parkinson's disease, also known as "tremor palsy", Parkinson's disease or Parkinson's disease, is more common after the age of 60. Mainly manifested as slow movement of the patient, tremors in the hands and feet or other parts of the body, the body loses softness and becomes stiff. The earliest systematic description of the disease was the British physician Jane Parkinson, who did not know which type of disease the disease should be classified into, saying that the disease was "tremor palsy." Parkinson's disease is the fourth most common neurodegenerative disease in the elderly, with 1% of people 65 years old, and 0.4% of people >40 years old. The disease can also occur in childhood or adolescence. 50% to 80% of the cases are insidious onset, and the first symptom is usually a 4-8 Hz resting "staple-like" tremor on one hand. Speech disorder is a common symptom in patients with Parkinson's disease.

Cause

Parkinson's disease is insidious in early symptoms, which can be manifested as a stiff or inflexible limb. The stride becomes smaller and the walking is slow. When walking, the normal swing of the limb is reduced or disappeared, and the voice is monotonously low. These symptoms are often thought of because of age. Growth, physical deterioration, and easy to be ignored.

an examination

Related inspection

Limb blood flow diagram EEG examination

Parkinson's disease is mainly caused by the degeneration of neurons that secrete dopamine in the human brain, leading to the lack of dopamine in the brain. Dopamine is a neurotransmitter, which is the trigger signal that the brain directs the movement of other parts of the body, and promotes all basic movements. Dopamine deficiency causes a series of symptoms such as tremor, stiffness and bradykinesia.

Differential diagnosis

The differential diagnosis of the elderly's slowness of action:

1. Parkinson's syndrome after encephalitis:

The Parkinson's syndrome caused by lethargy encephalitis has not been reported for nearly 70 years, so Parkinson's syndrome disappears after encephalitis caused by this encephalitis. In recent years, patients with viral encephalitis have been reported to have Parkinson-like symptoms, but this disease has obvious infection symptoms, which may be accompanied by symptoms of nervous system damage such as cranial nerve palsy, limb paralysis, convulsions, and coma. The number of cells in the cerebrospinal fluid may be light. Moderate increase, protein increase, sugar reduction, etc. After the condition is relieved, the Parkinson-like symptoms are relieved and can be differentiated from Parkinson's disease.

2. Hepatolenticular degeneration:

Recessive hereditary diseases, about one-third of family history, adolescent onset, may have increased limb muscle tone, tremor, mask-like face, torsion and other extrapyramidal symptoms. It has characteristic features such as liver damage, corneal KF ring and serum ceruloplasmin decrease. Can be differentiated from Parkinson's disease.

3. Idiopathic tremor:

Is a dominant genetic disease, manifested as head, jaw, limb involuntary tremor, tremor frequency can be high or low, high frequency is similar to hyperthyroidism; low frequency is similar to Parkinson's tremor. The disease has no reduction in exercise, increased muscle tone, and posture reflex disorder, and disappears after drinking, and the treatment of heart and sedative can be differentiated from primary Parkinson's disease.

4. Progressive supranuclear palsy:

The disease is also common in middle-aged and elderly people, and the clinical symptoms may include extrapyramidal symptoms such as muscle rigidity and tremor. However, this disease has prominent eye gaze disturbance, muscle rigidity is heavy on the trunk, limb muscle involvement is light, and the flexibility of the limb is maintained, and the neck extensor tension is increased. The neck overextension is obviously different from the neck flexion of Parkinson's disease. Can be identified with Parkinson's disease.

5. Shy_Drager syndrome:

Clinically, there are often extrapyramidal symptoms, but because of prominent autonomic symptoms, such as: syncope, orthostatic hypotension, sexual function and bladder dysfunction, levodopa preparations are ineffective, and can be differentiated from Parkinson's disease.

6. Drug-induced Parkinson's syndrome:

Excessive use of reserpine, chlorpromazine, haloperidol and other antidepressants can cause extrapyramidal symptoms, due to a significant history of medication, and can be identified after withdrawal.

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