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St. Paul's/Hollywood Library
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Otranto Road Library
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Keith Summey North Charleston Library
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John's Island Library
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Hurd/St. Andrews Library
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Miss Jane's Building (Edisto Library Temporary Location)
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Dorchester Road Library
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Baxter-Patrick James Island
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Parkinsono liga ir kiti judėjimo sutrikimai SARS-CoV-2 sukeltos pandemijos kontekste.
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- Author(s): Lokominienė, R. Kaladytė1
- Source:
Neurologijos Seminarai. 2020, Vol. 24 Issue 2, p125-131. 7p.- Subject Terms:
- Source:
- Additional Information
- Alternate Title: PARKINSON'S DISEASE AND OTHER MOVEMENT DISORDERS IN TIIE CONTEXT OF THE SARS-COV PANDEMIC.
- Abstract: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is able to invade the human nervous system and can cause headache, nausea, vomiting, febrile seizures, encephalopathy, encephalitis, ataxia or psychiatric disorders, as well as quantitative disturbances of smell and taste which arc observed both during the course of Parkinson's disease and other al-pha-synucleinopathies, only in slowly progressive and irreversible manner. The penetration of SARS-CoV-2 into the brain damaged by Parkinson's disease can enhance the clinical burden of movement disorder and increase the deficit for substitutional dopaminergic therapy. To date, there are no randomised controlled trials of COVED-19 outcomes in cases of Parkinson's disease and other movement disorders though patients of this category can be more vulnerable because of rigidity or dissinergy of respiratory musculature, diminished cough reflex, impaired swallowing, and chronic dyspnea. Indirect aggravating factors during the pandemic include stress, sc If-isolation, anxiety, and prolonged hypomobility which have a negative impact on the clinical burden of movement disorder and predispose weakened immune reactions. The compulsory limitations of contacts with physicians and relatives make cognitively impaired patients more prone to violations of medication regimen. In this case, teleneurology is a perspective mode of medical care for patients with movement disorders during the pandemic. Amantadine and memantine are presumed to have some anti-S ARS-CoV-2 potential but this assumption should be confirmed in clinical trials. International Parkinson Disease and Movement Disorders Society has published recommendations and priorities for patients with Parkinson's disease and other movement disorders during the COVID-19 pandemic which state that all measures of social distancing currently in place for the general population almost globally must be strictly and carefully practiced, direct consultations must be held in exceptional cases (e.g., for adjusting or checking deep brain stimulation programming, battery failure, levodopa duodenal pump treatments, botulinum toxin therapy), and patients should be encouraged to use sports equipment available at home and/or play virtual reality games. In case COVID-19 is diagnosed, the physician must ensure the maintenance of previous medications, especially adequate doses of levodopa/peripheral decarboxylase inhibitor to avoid rigidity with contractures and respiratory impairment with reduced vital capacity and peak expiratory flow. [ABSTRACT FROM AUTHOR]
- Abstract: Antro tipo sunkų ūminį kvėpavimo takų pažeidimo sindromą sukeliantis koro-navirusas (SARS-CoV-2) gali pažeisti žmogaus nervų sistemą ir sąlygoti galvos skausmą, pykinimą, vėmimą, febrilinius traukulius, encefalopatiją, encefalitą, ataksiją ar psichikos sutrikimus, taip pat kiekybinius uoslės ir skonio pakitimus, kurie būdingi irParkinsono ligai (PL) bei kitoms alfa sinukleinopatijoms, tik progresuoja lėtai ir būna negrįžtami. SARS-CoV-2 penetravus į PL pažeistas galvos smegenis, gali pasunkėti klinikiniai judėji mo ligos simptomai ir padidėti pakaitinės dopaminerginės terapijos poreikis. PL ar kitais judėjimo sutrikimais sergančių asmenų COVID-19 padarinius vertinančių atsitiktinių imčių tyrimų kol kas nėra, tačiau šios grupės asmenys galėtų būti stipriau pažeidžiami dėl kvėpavime dalyvaujančių raumenų rigidiškumo ardissineigijos, silpnesnio kosulio reflekso, sutrikusio rijimo, lėtinės ligos sukelto dusulio. Netiesioginiai veiksniai, kylantys pandemijos metu, -stresas, saviizoliacija, nerimas, ilgalaikis hipomobilumas, sunkina judėjimo sutrikimo klinikines išraiškas irpredisponuoja silpnesnes imunines reakcijas į infekcijas. Dėl ribotų kontaktų su medikais ir artimaisiais kognityvinių sutrikimų turintys pacientai gali dažniau pažeisti vaistų vartojimo režimą, todėl teleneurologija yra perspektyvi pagalba judėjimo sutrikimų turinčiam pacientui pandemijos metu. Yra prielaidų, kad amantadinas ir memantinas galėtų pasižymėti anti-SARS-CoV-2 potencialu, tačiau reikalingi klinikiniai tyrimai. Tarptautinė Parkinsono ligos ir judėjimo sutrikimų draugija pateikė rekomendacijas sergantiesiems Parkinsono liga ir kitais judėjimo sutrikimais COVID-19 pandemijos metu, kur nurodė griežtai laikytis bendrai populiacijai taikomų socialinių kontaktų ribojimo priemonių, tiesiogiai apžiūrėti pacientą tik išimties atveju (pvz., norint koreguoti giliųjų pamato branduolių stimuliatoriaus programą ar bateriją, duodenalinės levodopos pompos veiklą, atlikti būtinas botulino toksino injekcijas), skatinti pacientus naudoti namuose prieinamas sporto priemones ar (ir) žaisti virtualios realybės žaidimus. Diagnozavus COVID-19, gydytojas turi užtikrinti tolesnį anksčiau judėjimo sutrikimui gydyti skirtų vaistų vartojimą (ypač adekvačias levodopos ir periferinės dekarboksilazės inhibitoriaus dozes), kad būtų išvengta sustiprėjusio rigidiškumo, kontraktūrų, gyvybinės plaučių talpos ir maksimalaus iškvėpimo tūrio sumažėjimo. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Neurologijos Seminarai is the property of Neurologijos Seminarai and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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