úhm;aùu iuÕ we;sjk mdlskaika
úhm;aùu ksid isÿjk iakdhq mßydksh iuÕ ne÷k zzmdlskaika
frda.hZZ ms<sn| woyi bx.%Sis cd;sl Y,H ffjoHjrfhl= jQ fÊïia mdlskaika úiska
uq,skau bÈßm;a lrk ,§' 1817 jif¾§ fuu ffjoHjrhd úiska frda.Skaf.a isref¾ fjõ,k iajNdjh iy isref¾ tla me;a;l mK ke;s iajNdjhla
ksÍlaIKh l<d' fï frda. ;;a;ajh Tyq tod y÷kajd ÿkafka Shaking
Palsy hk kñka' miqld,Skj fuu fjõ,k frda. ,laIK fjku frda. ;;a;ajhla f,iska
meyeÈ,sj y÷kd .ekSug yels jqKd' uq,skau fuu woyi bÈßm;a l< ffjoH fÊïia mdlskaikaf.a y÷kd
.ekSug .re lsÍula f,i fuu frda. ;;a;ajh zzmdlskaika frda.h ZZhkqfjka kï l<d'
mdlskaika frda.h we;sùug fya;= fudkjdo@
jhig hEfï§ ñksia fud<fha ksmojk fvdmñkaa (Dopamine) kue;s ridhk ix>glh wvq ùu
^fvdmñka ksmojk ffi, m%udKh ksid& mdlskaika frda.h we;s ùug m%Odk fya;=j
f,i ffjoH úoHd;aulj fmkajd fokjd' fvdmñka ridhkfha ksis ls%hdldÍ;ajh u.ska
mqoa., YÍrfha iakdhq iy udxY fmaYSka iudfhdack bßhõ ksis mßÈ mj;ajd .ekSug
WmldÍ fjkjd'
wfma fud<fha fud< oKav m%foaYfha l¿ mod¾: (Substantia Nigra) fldgila we;'
ksfrda.S mqoa.,fhl=f.a fuu m%foaYh l¿ jk w;r mdlskaika frda.Skaf.a tu l¿ mod¾: olskak ,efnkafka keye' fuhg fya;=j
Tjqkaf.a fud< oKav m%foaYfha fvdmñka ridhkh wvqùuhs'
mdlskaika frda.sfhl=f.ka olsk m%Odk frda. ,laIK
1' frda.shdg weú§fï wmyiq;dj
2' fjõ,Su iy ;ukag wjYH mßÈ isrer yiqrejd
.ekSfï wmyiq;dj
3' frda.shdf.a isref¾ olakg ,efnk ukao.dñ;ajh
(Slowness)
fuu frda.Ska weúÈk úg;a my; ,laIK fmkakqï
lrhs''
³<Õ <Õ wä ;nd weú§u
³l=ÿ ù weú§u
³weúof.k hk úg l%ufhka fõ.h jeä ùu
³weúÈk úg isÿjk wf;a meoa§u wvqúu
³ukao.dñ;ajh (Slowness) ksidu mdlskaika
frda.Skaf.a uqyqfKka yeÕSï ( body language) m%ldY fjkafka keye'
fuu frda. ,laIK uQ,slj we;s jqK;a ld,h;a iuÕ frda.h j¾Okh
jkúg isref¾ iu;=,s;;djo ì| jefgkjd' ld,h;a iuÕ u;lh wvq ùu" l,amkdj wvq ùu
jeks udkisl frda. ;;a;ajhka olajd j¾Okh ùug bv we;' mdlskaika frda.hg cdkuh
miqìula iy mdßißl fya;=ka ;sfnkjd' mdlskaika frda.h jhi;a iuÕ we;sjk nj lsõj;a
l,d;=rlska wvq jhia ldKavfha whg;a mdlskaika frda. ;;a;ajh we;s fjkak mq¨jks'
idudkHfhka jhi wjqreÿ 60 blau jQ
mqoa.,hkaf.ka 1'5] isg 2'0 ] la jeks m%;sY;hla mdlskaika frda. ;;a;ajhg f.dÿre
jk neõ y÷kdf.k ;sfnkjd'
mdlskaika frda.h fkdjk kuq;a tu frda. ,laIK fmkajk ;j;a
;;a;ajhka lSmhla ;sfnkjd'
ú,aaika ^Wilson) frda.h ksid" udkisl frda.j,g
,nd .kakd we;eï ^anti-Psychotics) T!IOj, w;=re
M,hla ksid" wd>d;h jeks frda. ;;a;ajhka ksid
mdlskaika frda.h uq,skau y÷kd .kak wmyiq úh yelshs'
mdlskaika frda.h y÷kd .ekSu fjkqfjka úfYaIs; reêr mÍlaIk
iy ialEka jeks mÍlaIK keye' frda. b;sydih iy frda.shd mÍlaId lsÍfuka mdlskaika
frda. ;;ajh .ek ;SrK .ekSug ffjoHjrhdg yelshdj ;sfnkjd'
ta jf.au fndfyda úg fï frda.h meyeÈ,sj y÷kd .ekSug hï
lsis m%udohla isÿ fjkjd' tu ksid frda.h ksYaph lsÍfï hï m%udohla isÿ úh yelshs'
tu m%udoh .eg¨jla f,i wm olskafka ke;' frda.shd uq,skau meñfKkafka mdlskaika
frda. ,laIK iuÕhs' Tjqka f.a frda. b;sydih úuik úg óg l,ska meje;s ;j;a frda.
,laIK meñKs,s lrkjd' tu frda. ,laIK kï nv úh<Su" w;a md fõokdj" .|
iqj| fkd±kSu iy kskao wdY%s; .eg¿ fõ'
mdlskaikaa frda.Skaf.a kskao wdY%s;j we;sjk .eg¨'''
mdlskaika frda.sfhl= kskao wdY%s;j
.eg¨ lSmhlg uqyqK fokjd'rd;%s ld,fha kskao fkd,eîu iy Èjd ld,fha§
ksÈu; .;sh' idudkH mqoa.,fhla ksod .ekSug .sh iekskau kskao wdrïN jkafka ksfrda.S mqoa.,fhl= kskao wdrïN ùug hï ld,hla
(Sleep latency) .; fjkjd'
we;eï mdlskaika frda.Skag kskao wdrïN ùu b;d
blaukska ^sleep attack& isÿ
fjkjd Tjqka wjÈ wjia:dfõ isg tljru kskao wdrïNhg .uka
lrk ksid fuu frda.Skag jdyk meoùu wk;=reodhl úh yel'
iuyr mdlskaika frda.Ska rd;%s ld,fha isysfkka
olsk foh fN!;slj lsÍu Tjqka fkd±kqj;aj isÿ fõ'idudkH mqoa.,hl= ksod.kakd ld,h REM sleep iy Non- REM - sleep hkqfjka wjia:d folkska hqla;hs'
REM (Rapid eye movement) sleep wjia:dfõ§ wfma
weia fõ.j;aj p,kh fjkjd' fï wjia:dfõ§ mqoa.,hd iïmQ¾Kfhkau wls%h ;;ajhlg ^paralysis ) m;ajk ksid isysk ÿgqj;a tajd fN!;slj ls%hd;aul jkafka
keye' kuq;a mdlskaika frda.Ska REM sleep wjia:dfõ§ wl%Sh ;;a;ajhlg ^paralysis ) m;a fkdjk ksid isysfkka olsk
foa fN!;slj lsÍug bv ;sfnkjd' WodyrKhla
f,i lsõfjd;a frda.shd isysfkka weú§u ^ Sleep walking & olajkak mq¨jka' fï ksid frda.shdg úúO
wk;=re isÿ fjkak;a bv ;sfnkjd'
mdlskaika l%ufhka j¾Okh
jkakla'''
mdlskaika frda. ;;a;ajh ld,h;a iuÕ j¾Okh jk frda.hla' fï
frda.h ksÜgdjgu iqj lrk T!Iëh m%;sldr ke;;a frda. ,laIK b;du fyd¢ka md,kh lrñka
frda.shdg hym;a Ôú;hla .; lsÍug wjia:dj i,id Èh yels m%;sldr l%u ;sfnkjd'
mdlskaika frda.hg
m%;sldr
mdlskaika frda.Ska fjkqfjka zzfvdmñka ZZ
ndysrj ,nd §u wjYHhs' th ,nd fokafka levodopa keue;s ^ WodyrK Syndopa, Sinemet & T!IOh u.ska' levodopa T!IOh ffjoHjrhd ks¾foaY lrk
fõ,djkays§ ,nd §u jeo.;a'
mdlskaika frda.Skaf.a ON iy OFF wjia:dj
mdlskaika frda.Ska p,kh ùfï wmyiq;djh fmkajk
wjia:dj OFF wjia:dj
hkqfjka y÷kajkjd' tu wjia:dfõ§ frda.shdg levodopa T!IOh ,nd ÿka úg frda.shd ls%hdldÍ
fjkjd' l%shdldÍ wjia:dj th ON wjia:dj hkqfjka y÷ka jkjd'
ffjoHjrhd yuqfõ§ b;sydih bÈßm;a lrk úg iuyr
frda.Ska ON iy OFF jpk mdúÉÑ lrñka frda. ,laIK bÈßm;a lrkjd' wms frda.Ska ±kqj;a lrkjd'
Dyskinesia
hkq
l=ulao@
§¾>ld,Skj ^jir .Kkdjla ;siafia & levodopa T!IOh ,nk we;eï mdlskaika frda.Ska dyskinesia
kue;s wjia:dj fmkakqï lrkjd' levodopa T!IO ,nd f.k ál fõ,djla hk úg frda.shd md,khlska f;drj
oÕ,k iajNdjhla fmkakqï lrkjd' fï wjia:d dyskinesia kï fõ' th b;d
iq¿ fõ,djla mj;skjd'
ffjoHjre úiska frda.shdg fyda Tjqka /ln,d.kakd whg ON " OFF iy dyskinesia wjia:djka wdrïNh iy wjidkh isÿjk fõ,djka igyka ;nd
.ekSug ±kqj;a lrkjd'fuu jd¾;djka Èkm;d ;nd .ekSu wjYH keye' tla Èkla ;=< ;nd
.kakd fuu jd¾;dj ffjoHjrhd fj; bÈßm;a lsÍu m%fhdackj;a' fuu jd¾;djka wkqj
ffjoHjrhd úiska frda.shdf.a ON wjia:dj §¾> lsÍug;a " OFF iy dyskinesia wjia:dj
wvq lsÍug;a W;aidy lrkjd'
mdlskaika frda.h iakdhq frda. ;;a;ajhla jk neúka iakdhq frda. ms<sn| ldhsl úfYaI|
ffjoHjrfhl= fj; fhduq ùu u.ska jeäÿr m%;sldr ,nd .; yel'
mdlskaika frda.Skag ,nd Èh yels fjk;a m%;sldr
mdlskaika frda.h W;aikak fjk wjia:dfõ§ ,nd Èh yels fjk;a
T!Iëh iy T!Iëh fkdjk m%;sldr ;sfnkjd' jeä ÈhqKq lrk ,o m%;sldr lSmhla fï jkúg
y÷kd f.k ;sfnkjd' f,dalfha fï frda. m%;sldr fjkqfjka myiqlï ;sfnkjd'
.eUqre uia;sIal W;af;ackh - Deep brain stumilation
fuu m%;sldr wjia:dfõ§ Y,Hl¾uhla u.ska
fud<h W;af;ackh lrk bf,lafg%davhla we;=¨ lsÍu isÿ fjkjd' th yDohjia;=fõ
W;af;ackh fjkqfjka we;=<;a lrk Pace maker yd iudk jQ l%uhla'
Duodopa intestinal gel infusion
ndysrj .%yKshg we;=¿ lrk nghla ;=<g duodopa
T!IOh wLKavj ,nd§u isÿ fõ'
jHdhdu w;HjYHhs'''
mdlskaika frda.Skag jHdhdu b;du jeo.;a' ta ú;rla
fkdfjhs" Tn wkd.;fha§ mdlskaika frda.h je<£ug kshñ; mqoa.,fhl= kï jHdhdu lsÍu u.ska frda.h wdrïN jk Èkh ÿria
lr.kak mq¨jka jkq we;' frda.h ±k .;a wjia:fjka miqj jqj;a jHdhdu lsÍu u.ska frda.shdg ±fkk wmyiq;djka
úYd, f,i wju lr .ekSug;a mq¨jks' idudkH Ydßßl jHdhdu" k¾;kh" fN!;
Ñls;ailhl=f. Wmldrh iys;j isÿ lrk jHdhdu m%fhdackj;a fjkjd'
k¾;kh jvd;a .e<fmkjd'''
mdlskaika frda.Skag k¾;kh fyd| YdÍßl
jHdhduhla' cmdkfha ghs ls (Tie -Chi) k¾;kh b;d id¾:l jHdhduhla neõ úoHd;aul wOHkhka u.ska ikd:
ù ;sfnkjd' fuu k¾;kh ;=< blauka iy wvq fõ.fha p,khka ixl,kh ù ;sfnkjd'
mdlskaika frda.h úhm;aùu iuÕ wm ldg;a we;s fjkak mq¿jks'ta
ksid wfma Ôjk rgdj hym;aj mj;ajd .ekSu u.ska wkd.;fha mdlskaika frda. ;;ajh
we;s ùu j,lajd .ekSug lghq;= lsÍu jeo.;a' WodyrKhla f,i my; i|yka lreKq jeo.;a
fõ'
³hym;a wdydr wkqNjh
³ls%hdldÍ Ôjk rgdj
³udkisl wd;;sfhka f;drùu
³u;ameka ÿïmdkfhka f;drùu
³iudc iïnkaO;djka mj;ajd .ekSu
³úhm;aùu iuÕ fud<fha fi!LH mj;ajd .ekSu
mdlskaika muKla fkdj úhm;a ùu iuÕ we;s jk ;j;a frda.S
;;a;ajhka ^wd>d;h" äfukaIshd& ;sfnkjd' hym;a Ôjk rgdj u.ska fuu frda.S ;;a;ajhkag o we;s lrk n,mEu wju lr .; yelshs'ta jf.au jhi iuÕ udkislj i;=áka isàu b;d jeo.;a' hym;a
iudc iïnkaO;djka f.dvkÕd .ksñka udkislj i;=áka isáug wjYH miqìu iQodkï lr .ekSu
jeo.;a' iñ;s iud.ï jeks iudc iïnkaO;djkays fh§ isák úg udkislj we;s yqfol,d nj
fndfydaÿrg ÿria ùu isÿ fjkjd' i;=g iuÕ fud<fha fvdmñka ridhkfha we;s
i;=gqodhl m%;spdr mqoa.,hdf.a ksfrda.S;djg jvd;a jeo.;a fjkjd' ta ksid Tn
mdlskaika frda. ;;a;ajfhka wdrlaId ùug kï hym;a YdÍßl iy udkisl fi!LHhla iuÕ
Tfí Ôjk rgdj ie,iqï lr .kak'
fldúâ 19 je<£u ksid mdlskaika frda. ;;a;ajhg m;aúh
yelso'''@
fldúâ 19 frda. ;;a;ajhg m;a frda.Ska wkd.;fha§ mdlskaika
frda. ;;a;ajhg f.dÿre ùfï wjodkula we;ehs hï u; m%ldY ù ;snqK;a' ta fjkqfjka
we;s úoHd;aul ±kqu ;ju;a w,amhs' fï ms<sn|j jeäÿr y÷kd .ekSï ;yjqre jkf;la
ta .ek ksYaaÑ; woyila bÈßm;a lsÍu wmyiqhs'
iakdhq frda.
ms<sn| úfYaI{ ffjoH
.dñKS m;srK
cd;sl
frday," fld<U
mqkHd pdkaokS o is,ajd