PARKİNSON HASTALIĞI BAŞLANGICINDA GÖRÜLEN AĞRI SIKLIĞI VE TANI SÜRESİNE ETKİSİ

Abstract

Amaç: Parkinson hastalığında (PH) ağrı gibi non-motor bulguların kas-iskelet sistemi hastalıkları ile daha çok ilişkilendirilmesi tanıda gecikmeler yaşanabileceğini düşündürmektedir. Bu çalışmada PH’de ağrı başta olmak üzere ilk semptomların ve başvurulan branşların gözden geçirilmesi ve bu başvuruların tanı ve tedavi süresine etkisini incelemek amaçlanmıştır. Gereç ve Yöntem: Çalışmaya PH tanılı hastalar dahil edildi. Hastalar klinik özellikleri, ilk yakınmaları ve yakınma başlangıç zamanı, ağrı yakınmasının varlığı ve tipi, ilk başvurdukları branş ve tanı süreleri yönünden değerlendirildi. Bulgular: Çalışmaya 86 hasta dahil edildi (42’si kadın, 44’ü erkek). İlk yakınma hareketlerde yavaşlık, tremor, tremor ve hareketlerde yavaşlık, omuz ağrısı, tremor ve ağrılı kasılma idi. Hastaların ilk yakınmaları 10,1±5,22 yıl önce başlamıştı, PH tanısı ise ortalama 8,56±4,87 yıl önce konmuştu. Yakınmaları nedeniyle ilk başvurulan branş 34 hastada Nöroloji, 34 hastada Fizik Tedavi ve Rehabilitasyon, 10 hastada Beyin ve Sinir Cerrahisi, 8 hastada Ortopedi idi. Nörolojiye ilk başvuru 8,7±4,85 yıl önce idi. Elli altı hastada ilk başvurudan 7,2±6,69 yıl önce ağrı yakınması başlamıştı. Ağrılı hasta grubunda kas-iskelet ağrısı %86, distonik ağrı %25, santral ağrı ve nöropatik ağrının her biri %11 oranındaydı. Sonuç: Parkinson hastalığı ağrı ve katılık gibi bulgular nedeniyle kas-iskelet sistemi hastalıkları ile karışabilmekte, bu durum tanı ve tedavi süresinin gecikmesine neden olabilmektedir. Nöroloji dışı branşlara hastalık hakkında daha detaylı eğitim verilmesi, halkın hastalık bulguları konusunda bilinçlenmesi bu gecikmenin önüne geçebilir.

Keywords

• Parkinson hastalığı
• ağrı
• non-motor semptomlar
• kas-iskelet semptomları

HOW THE FREQUENCY OF PAIN IN THE EARLY STAGES OF PARKINSON’S DISEASE AFFECTS THE SPEED OF DIAGNOSIS

Abstract

Objective: The fact that non-motor symptoms such as pain in Parkinson’s disease (PD) are more associated with musculoskeletal diseases (MSD) suggests that there may be delays in diagnosis. The aim of this study was to review the first symptoms of PD, especially pain, while at the same time reviewing the medical specialists to whom patients first went and examining the effects of these parameters on time to diagnosis and treatment. Materials and Methods: Patients with PD were included. The patients were evaluated in terms of clinical features, initial complaints and onset time, presence and type of pain, the medical specialist they first applied to, and time to diagnosis. Results: Eighty-six patients were included (42 female, 44 male). The first complaints were bradykinesia, tremor, tremor and bradykinesia, shoulder pain, tremor and painful cramps. These complaints started 10.1±5.22 years previously, and the diagnosis of PD was made 8.56±4.87 years previously on average. The first specialist departments to which patients with these complaints applied were Neurology (n=34), Physical Therapy and Rehabilitation (n=34), Neurosurgery (n=10), and Orthopedics (n=8). The first admission to Neurology was 8.7±4.85 years previously. Pain complaints started 7.2±6.69 years before the first admission in 56 patients. Musculoskeletal pain was 86%, dystonic pain was 25%, central pain and neuropathic pain were 11% each in the group of patients who had experienced pain. Conclusion: PD can be confused with MSD due to findings such as pain and rigidity, which may cause a delay in diagnosis and treatment. This delay can be prevented if non-neurology specialists are provided with more detailed training about the disease, and if public awareness is raised about the signs and symptoms of PD.

Keywords

• Parkinson’s disease
• pain
• non-motor symptoms
• musculoskeletal symptoms

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