According to information, 50,000 new Parkinson’s disease patients appear in the United States each year. Estimates put the number of Parkinson’s disease patients in the United States between 500,000 and 1.5 million. Because Parkinson’s disease is more common in people 60 years of age and older, the incidence is expected to increase as the baby boomers age. Although Parkinson’s disease is more common in older adults, some people begin to experience symptoms before the age of 40. Clinical Manifestations of Parkinson’s Disease Due to a decrease in dopamine and an increase in acetylcholine in the substantia nigra of the brain, the patient’s limbs begin to “misbehave” and do not listen as well to the brain’s commands. For example, the patient wants to hold a pen to write, but the neurotransmitters can not transmit the nerve impulse signals normally, so the patient’s hand can not “obediently” move the pen smoothly, but trembling, or so stiff that it “refuses to move”. It is very difficult for the patient to stand up from a chair. Even basic living skills such as eating, drinking and dressing are affected. Since the occurrence and effects of the disease are different for each person, the clinical manifestations are also different. It is necessary to have the appropriate knowledge of the disease, but do not make a diagnosis by rigidly applying the following entries to yourself! From the description of the observed classification of clinical medicine, the main symptoms of Parkinson’s disease have four major categories: 1, resting tremor: the patient occurs limb trembling, more pronounced when resting, which is the most common situation. This is the result of alternating, regular activity of the active and antagonist muscles of the muscle group affected by the diseased nerve. This symptom can begin early on one limb and is more common in the upper limbs, with more pronounced manifestations in the fingers and palms (distal) than in the forearms and upper arms (proximal). It is usually 4 – 8 times per second with a small amplitude; typically it is a “pill-rolling (pill-rolling) movement” at rest, which can be temporarily controlled; a few have a large amplitude and tremor during the movement. Reduced or disappeared in random movements, disappeared after going to sleep; exacerbated by nervousness and emotional excitement. 2, muscle ankylosis: can be an early symptom, for the active muscle and antagonist muscle tension increases at the same time, in the same time with the tremor of the patient, when pulling the patient has a feeling of tightening and loosening, the medical description is called “passive movement of the ‘gear-like’ ankylosis”, which is also when the This is also one of the typical clinical manifestations of Parkinson’s disease. 3, movement disorders: due to the reduction of neurotransmitters, nerve impulses can not be fully expressed in the limbs, trunk and all the muscles of the whole body, so there is a reduction in movement or movement can not. This is the main reason why patients gradually lose the ability to live. When the patient wants to move, he or she cannot start the motor process normally, for example, when he or she wants to stand up and walk from a chair, he or she cannot stand up quickly, and when he or she wants to walk, he or she cannot take a step for a while. Sometimes, when walking, it is as if the patient suddenly “freezes” and cannot take a step. In addition, speech is difficult, slowed down, facial expression muscle movement is reduced, manifested as a lack of expression, transient eye reduction, known as the “mask face”. In severe cases, it is difficult to compose sound, chew, swallow, and salivate; the accompanying movements of the upper limbs are reduced and disappear; it is difficult to change movement, fine motor difficulty, and micrographia, etc. 4, posture maintenance and balance disorders: normal, if you need to maintain a certain posture, such as standing, then all the muscles from the feet and legs to the trunk and upper limbs need to have just the right strength to maintain the body will not fall. The regulation of the tone of individual muscles and muscle groups is something that requires an immediate judgment by the brain about the postural state being maintained and immediate feedback to the individual muscles to perform. Since Parkinson’s disease is accompanied by reflex postural dysregulation of active movements, difficulties in balance and postural regulation can constitute some of the characteristic postures. For example, it is not possible to “hold the head high” and become “forward-flexed” posture, and there is “panic-like gait” when walking. (1) Monotonous speech, whisper-like repetitive speech, and voice tremor unrelated to tremor. (2) Autonomic dysfunction. (3) Frequent complaints of muscle aches and pains (more common in the lower limbs), nocturnal muscle spasms, and visceral discomfort. (4) Sleep disturbances, inability to sit still, psychiatric symptoms such as agitation, anxiety, and depression (40%), dementia in about 20% of Parkinson’s patients, and increased rates of advanced dementia (14%-80%). Patients with Parkinson’s disease usually have a “panicky” gait, tremors in the arms and lower limbs at rest, and muscle rigidity and flexion. In some cases, cognitive (thinking, judgment and memory) deficits are also present. Patients with Parkinson’s disease may also experience the following symptoms 1. Depression: About 40% of patients with Parkinson’s disease experience depression, which can be treated with medication and/or psychotherapy. It is important that patients with Parkinson’s disease and their caregivers report symptoms of depression to their physicians. 2. Memory loss, confusion and/or dementia: Studies have shown that more than 50% of PD patients have mild mental decline and about 20% have cognitive impairment. Memory loss is less severe in Parkinson’s disease than in Alzheimer’s disease. Patients with Parkinson’s disease may have difficulty concentrating, learning, and recalling names. Because high doses of certain medications used to treat Parkinson’s disease can cause hallucinations or confusion, medications taken by patients with Parkinson’s disease should be closely monitored. Dementia occurs in about 25% – 40% of patients with Parkinson’s disease. Patients with cognitive problems, including dementia, cannot be treated surgically. 3. Speech disorders: About 60% – 90% of patients with Parkinson’s disease develop speech disorders. Patients with Parkinson’s disease may speak with a single tone of voice and with reduced volume (weak articulation). Dysarthria refers to dysarthria, which is usually characterized by weak, slow, or incoherent speech that can affect volume and/or pitch. The voice is hoarse or comes out in short bursts. Often speech disorders worsen as they progress over time. Speech therapy can be helpful in relieving the speech disorder. Dysphagia: Swallowing problems (dysphagia) occur in at least 50% of people with Parkinson’s disease and can cause drooling, spilling of food or liquids from the mouth, or food being sent to the back of the throat before swallowing. Parkinson’s disease patients and their chaperones should be aware of signs of choking, the presence of food stuck in the throat, or increased obstruction after eating. Patients with Parkinson’s disease also have an increased likelihood of developing pneumonia due to the difficulty of cleaning the lungs by coughing up sputum. Speech therapy for the patient can also help improve swallowing problems. There is also fidgeting, writing difficulties, anxiety, urinary tract infections, excessive sweating, sexual dysfunction, sleep disorders, eyelid closure, skin problems, and lack of facial expression. Clinical symptoms in patients with Parkinson’s disease are not entirely consistent and symptoms change as the disease progresses.