Parkinson’s disease treatment in Iran

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Parkinson’s disease treatment in Iran

parkinson treatment iran

Surgery for Parkinson's disease in Iran

Parkinson's disease is a progressive disorder of the nervous system that affects voluntary movement.

Symptoms vary person to person and typically affect one side of the body first , even as they worsen. Traditionally total cure was never possible and patients were put on medications to manage their worsening symptoms.

Parkinson disease can progressively affect quality of life , with symtomps such as:

Tremor - Tremor in a limb, often in the hand or fingers at rest, a back-and-forth rubbing of your thumb and forefinger, known as "pill-rolling"Slowed voluntary movement (bradykinesia) - Reduced ability to move and walk, and dragging feet with smaller steps as well as difficulty in rising from sitting/getting out of a bed/chairOrthostatic hypotension - Lightheadedness or dizzy when standingRigid muscles - Muscle stiffness and abnormal tone in the body limiting your motion and causing painImpaired posture and balance - Stooped posture, unsteady balanceLoss of automatic movements - Decreased facial movement like blinking, smiling or swinging your arms when you walkDysarthria - Difficulty in speaking and speech-related problems like speaking softly, quickly, with a slur or hesitation, monotonous without inflectionsDysphagia - Difficulty in swallowingWriting changes - Difficulty to write, and writing may appear small.

parkinson disease in iran

What is the treatment process of Parkinson’s disease?

A: As on date, there is no permanent solution found for Parkinson's disease. Medications are the most beneficial form of treatment. Some medications for PD are given below:

Carbidopa
Pergolide (Permax)
Ropinirole (Requip)
Pramipexole (Mirapex)
Bromocriptine (Parlodel)
Amantadine (Symmetrel)
Entacapone (Comtan)
Selegiline (Eldepryl)

What is DBS?

Deep brain stimulation (DBS) is a surgical procedure used to treat a variety of neurological symptoms-most commonly the symptoms of Parkinson's disease (PD), such as tremor, rigidity, stiffness, slowed movement, and walking problems. The procedure is also used to treat essential tremor, a common neurological movement disorder. DBS does not damage healthy brain tissue by destroying nerve cells. Instead the procedure blocks electrical signals from targeted areas in the brain.

DBS is often described as a pacemaker for the brain. It works much like a pacemaker, sending electrical signals to the brain instead of the heart. It is primarily utilized for patients who have Parkinson's disease, dystonia, or essential tremor (ET), and who can’t adequately control their disease with medication.

For those with Parkinsons's, DBS can reduce tremors and significantly improve slowness and stiffness; and make tremors disappear for those with ET. DBS can help relax muscles and improve abnormal postures caused by muscle contractions for those with dystonia. In all cases, DBS can help enhance quality of life.

It's important to understand that DBS does not offer a cure for your disease, but a way to manage it more effectively. It can offer many benefits, including the need to take less medication and therefore experience fewer medication side effects.

When is a good time to consider DBS?


Am I a good candidate?
There are somewhat different criteria for determining if DBS is a good option for you based on your diagnosis and condition. For Parkinsons disease, DBS is typically helpful if you experience motor fluctuations or tremors that interfere with activities that are not already adequately managed by medication, are not improved by changes in medication, or you experience side effects that prevent you from taking higher doses. For ET, DBS may be considered if you have tremors that interfere with your quality of life and cannot be controlled adequately with medications. Other key factors considered are age in combination with general health, a solid support system of family and friends, absence of dementia or an active psychiatric illness such as severe depression, and realistic expectations for treatment outcomes.

Before any patient is considered for DBS surgery, they are evaluated by the U-M Surgical Therapies Improving Movement (STIM) multidisciplinary team, which has extensive training in DBS. The STIM team includes a neurosurgeon, neurologist, clinical neuropsychologist, speech pathologist, social worker, and other team members who ensure that you and your family understand the procedure and discuss your expectations and concerns.

DBS Surgery technique in Iran

MRI Brain is done one day before surgery to see the deep nuclei (subthalamus) of brain.
Patient is kept off medication for 12 hrs.
This surgery is done under local anesthesia and sedation.
On the day of surgery Stereotactic frame (Leksell, ZD Frame) is fixed
under local anesthesia, and then patient is taken to Radiology
Department for CT Scanning.


The subthalmic target is calculated by fusing CT Scan and MRI images on work station.
In the operation theatre two small holes in th skull are made, Micro electrode recording is done using 5 channel MER. After analyzing the recording of MER, the track which has longest and strongest signal of sub thalamus chosen for the stimulation. If stimulation confirms the reduction of tremor,stiffness and slowness in operation theatre DBS lead is placed in that track using C-arm.
DBS lead is placed in that track using C-arm.
DBS lead is connected to IPG (Kinetra, Libra XP "Non Reahcrgeable" and Braio "Rechargeable") under general anesthesia. This procedure is done on the same day or can be done after one day under general anesthesia.

 

After the Deep Brain Stimulation electrodes implantation, the next important step of this surgery is programming. Initial programming is done in two weeks time and later-on further programming is done as out patient basis in subsequent visits.Patient can himself programme using hand held patient's programmer under guidance of a neurologist or programming assistant.

What is the cost of Parkinson’s disease treatment in Iran?


The cost of Parkinson’s disease treatment in Iran start from $6000 and deep brain stimulation surgery cost start from $8000. The cost may vary depending on the type of treatment opted by the patient, number of travelers, number of days required for treatment and more.

How does one can define Parkinson’s disease (PD)?


It is a progressive neurological disorder of the brain. It was first defined by Dr. James Parkinson. He wrote a paper “Essay on the Shaking Palsy” in 1817 in which he first described this disease. The average age of start for Parkinson’s disease is 60 years; however, it can be found in people much younger.

What are causes of Parkinson's Disease?


A: When the area of the brain identified to be substantia nigra encounters with impairment of nerve cells, Parkinson's disease is caused at that point in time. These nerve cells while functioning normally produce a vital brain chemical known as dopamine. Dopamine acts as a chemical messenger that communicates between the substantia nigra and another area of one's brain known to be basal ganglia. Smooth and balanced movement of muscles is possible by this communication. A deficiency of dopamine makes abnormal nerve functioning that causes inability to control body movements.

Is Parkinson's disease curable?


A: Parkinson's disease is not fully curable so far as modern medical science is concerned.But, by detecting individual symptoms and regulating a proper course of treatment, many patients with the disease can live a comfortable life.

Is there any prevention for Parkinson's disease?


Till date, no way is found to prevent Parkinson's disease. But, options like, drug therapy, surgery can lower the symptoms, and make life with the disease easier.

1What is the best treatment for Parkinson disease?
Levodopa and carbidopa (Sinemet). Levodopa (also called L-dopa) is the most commonly prescribed medicine for Parkinson's. It's also the best at controlling the symptoms of the condition, particularly slow movements and stiff, rigid body parts. Levodopa works when your brain cells change it into dopamine.
2What are the five stages of Parkinson's disease?
Stage three of Parkinson's disease. Stage three is considered mid-stage and is characterized by loss of balance and slowness of movement. Balance is compromised by the inability to make the rapid, automatic and involuntary adjustments necessary to prevent falling, and falls are common at this stage.
3What do Parkinson's patients usually die from?
You die with Parkinson's disease, notfrom it. However, as symptoms worsen they can cause incidents that result in death. For example, in advanced cases, difficulty swallowing can cause Parkinson's patients to aspirate food into the lungs, leading to pneumonia or other pulmonary conditions.
4What are the 5 stages of Parkinson disease?
The rating scale will assess motor symptoms such as movement and tremors, as well as non-motor symptoms such as loss of smell. There are five different stages of Parkinson's disease, starting with mildest and leading up the most severe. There are commonalities in each stage, but the severity of symptoms will differ.
5What is the life expectancy of someone with Parkinson's disease?
With an average PD onset age of 60 years, the relevant comparator is 23.3 years, the general population's life expectancy from that point. Resourceful patients may learn these figures from Dr. Google, but might find it difficult to extract a more personalized prediction from a neurologist.
6How long can a person live with Parkinson's disease?
Individuals with PD have a somewhat shorter life span compared to healthy individuals of the same age group. Patients usually begin developing the disease around age 60, and many live between 10 and 20 years after being diagnosed.
7What is the best exercise for Parkinson's disease?
Certain exercises may be helpful for specific motor symptoms of Parkinson's: For balance, consider tai chi and yoga. To improve coordination and agility, look into dancing or boxing. For significant balance problems or limited mobility, seated aerobic exercises can give a challenging workout that raise the heart rate.
8What are the four cardinal signs of Parkinson's disease?
Four symptoms are considered cardinal in PD: bradykinesia, tremor, rigidity, and postural instability also referred to as parkinsonism.
9What kills a person with Parkinson's disease?
There is no definitive diagnosis of Parkinson's disease until death. ... Parkinson's disease doesn't kill you. Symptoms it causes can lead to problems that do – such as problems with swallowing leading to choking and pneumonia, or falling and breaking a bone or hitting the head, and then never fully recovering.
10What are the final stages of Parkinson disease?
In end-stage of Parkinson's disease, patients will also often experience non-motor symptoms. These can include incontinence, insomnia, and dementia.

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8 Comments

  1. joy_orag says:

    Can Parkinson’s be cured?

    • Iranian Surgery Adviser says:

      Not yet. However, many PD symptoms can be treated and researchers are making advances in understanding the disease, its causes and how to best treat it

  2. danial. says:

    Is there a special MS diet?

    • Iranian Surgery Adviser says:

      There is no specific dietary recommendation for MS. For someone without MS, certain aspects of how you eat have been shown to reduce the risk of MS. Specific diets have been shown to improve certain symptoms in those with MS.
      Decreasing Risk
      Studies that examine patterns in health across specific populations demonstrate that a “Westernized” diet (high in fat, salt, sugar, and processed food, and low in vegetables) is associated with increased MS risk. Moreover, obesity is a risk factor for developing MS, possibly because it contributes to chronic inflammation. These facts, taken together, indicate that diet may be a factor in developing MS, but it remains to be seen whether diet can play a role in stopping the disease.
      Improving Symptoms
      While no diet regimen has been shown to slow, stop, or reverse the damage caused by MS, specific diets have shown some benefit for symptom management in clinical trials.
      Among those diets that have shown positive trial results, the most noted effect was a reduction in fatigue. Participants also improved their general health, including weight and blood lipid levels. Among these diets studied specifically for MS, there are some differences and similarities.

  3. arjandaa says:

    How is Parkinson’s inherited?is it about genetic mutation?

    • Iranian Surgery Adviser says:

      Studies show that some cases of Parkinson’s disease are caused by geneticmutations. Hereditary causes of this disease are rare. Only 15 percent of those who have Parkinson’s disease have a family history of it. … Research suggests that a combination of genetic and environmental factors may cause Parkinson’s disease

  4. devon says:

    Is there any drug for Parkinson to introduce to me?

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