How is the teenager's hand shaking?

Parkinson's disease, formerly known as Parkinson's disease, is a common chronic disease, more common in middle-aged and elderly people, which is caused by the functional degradation of a small group of brain cells in a specific part of the deep brain. The typical manifestations of Parkinson's disease are limb tremor, muscle rigidity and general motor retardation. Other manifestations include decreased facial expression, increased skin oil secretion, low voice, decreased blinking and swallowing, drooling, smaller writing, decreased natural swing of the affected upper limb when walking, sudden "stiffness" of the leg when stepping, foot dragging on the affected side, unstable posture, and low mood. However, a very small number of patients will have all the above manifestations at the same time, especially in the early stage of the disease, and the symptoms are usually atypical. For example, the arms are weak and weak, the legs sometimes can't be lifted, and it is easy to get tired. Some fine movements become slow and laborious, such as not brushing your teeth, not tying buttons, not tying your shoelaces, and your voice is low and hoarse. Parkinson's disease is not a life-threatening acute disease, and the progress of these symptoms is not very fast, so even if you suspect that you have Parkinson's disease because of some signs, you don't have to be too impatient. It may take some time to observe and diagnose and rule out other diseases.

Three surgical treatments for Parkinson's disease

At present, there are three surgical treatments for Parkinson's disease, namely destruction, brain cell transplantation and brain pacemaker treatment.

1. Brain cell transplantation and gene therapy

Brain cell transplantation and gene therapy for Parkinson's disease have achieved great success in animal experiments, but recent clinical studies show that embryonic brain transplantation can only slightly improve the symptoms of patients under 60 years old, and 50% of patients have voluntary movement's side effects after operation. So this operation is not suitable for general use at present. Gene therapy is still in the laboratory stage.

Step 2 destroy

Destruction (such as using microelectrode recording technology to locate the target, which is also commonly known as "cell knife") is to destroy the abnormally excited nuclei in the brain, mainly globus pallidus and ventrolateral thalamus, by electric cauterization. The effect of destruction has been recognized, but destruction is a destructive operation, and the long-term effect of some patients is not ideal. About 4% of patients have complications such as cerebral hemorrhage and target deviation, and in severe cases, they have hemiplegia, coma and even life-threatening. Destruction can only be carried out on one side, that is, to control the symptoms of one limb. However, 90% of Parkinson's patients have bilateral limb symptoms and head and face symptoms. Only bilateral surgery can achieve the ideal therapeutic effect for these patients. Simultaneous bilateral brain surgery is not easy, and the complications of staged bilateral surgery are also high, reaching 30%. Most patients have symptoms such as decreased voice, slow swallowing, drooling and fatigue after operation. At present, this kind of operation is rarely performed abroad. Therefore, destruction has obvious shortcomings, and bilateral destruction is more difficult to advocate.

3. Brain Pacemaker Therapy

The treatment of brain pacemaker is only to implant stimulation electrodes into specific parts of the brain and achieve therapeutic effect through chronic electrical stimulation. It is a reversible neuromodulation therapy, which does not destroy brain tissue and affect other new treatment methods in the future, thus embodying the principle of minimally invasive surgery. The therapeutic effect of brain pacemaker is better than the focus, and it may also protect the substantia nigra tissue, play a role in treating the etiology and delay the progress of Parkinson's disease itself. In vitro, the stimulation parameters can be set by computer programming, the stimulation intensity and frequency can be adjusted at any time, and the best stimulation contact point can be found. The curative effect is better and the duration is longer. It has been followed up for 8 years abroad. For patients with Parkinson's disease with bilateral symptoms, both sides can be implanted with stimulating electrodes at the same time, and all symptoms can be solved by one operation. Surgical treatment is relatively safe, complications and side effects are generally reversible, and the operative mortality rate is below one thousandth. We have performed more than 120 cases of brain pacemaker surgery for Parkinson's disease without any permanent complications and side effects. Brain pacemaker therapy has gradually replaced destructive surgery, which is the most ideal surgical treatment method at present, and is considered as the second milestone in the treatment of Parkinson's disease (the first milestone is levodopa invented by 1968). The disadvantage of brain pacemaker therapy is its high cost. Generally, the battery of the pulse generator can only be used for 5 to 8 years, and then the chest pulse generator needs to be replaced.