Step 1: Diagnosing Parkinson’s syndrome
Decrease in movement: Random movements are slow at the onset, with a gradual decrease in the speed and amplitude of movement for repetitive movements, along with at least one of the following symptoms.
A. muscle tonicity
B. resting tremor (4-6 Hz)
C. Upright instability (caused by non-primary visual, vestibular, cerebellar and proprioceptive dysfunction)
Step 2: Parkinson’s disease exclusion criteria
History of recurrent stroke with stepwise progression of Parkinson’s symptoms
History of recurrent brain injury
definite history of encephalitis
moving eye crisis
being treated with neuroleptics at the time of symptom onset
1 or more relatives with the disease
Persistent remission of disease
Strictly unilateral involvement three years after onset
supranuclear gaze palsy
cerebellar signs
Severe autonomic involvement at an early stage
Severe early dementia with memory, speech and behavior deficits
Positive pyramidal fasciculus sign (Babinski’s sign +)
Intracranial tumor or traffic hydrocephalus on CT scan
Ineffective treatment with high doses of levodopa (except for absorption disorders)
MPTP exposure history an opioid analgesic derivative
Step 3: Supporting diagnostic criteria for Parkinson’s disease. The diagnosis of Parkinson’s disease is confirmed by having three or more
Unilateral onset
Presence of resting tremor
Progressive disease progression
Persistent asymmetry of symptoms, with the first side being more severe
Very good response to treatment with levodopa (70-100%)
Severe allodynia due to levodopa application
Treatment effect of levodopa lasts for more than 5 years (including 5 years)
Clinical disease duration of more than 10 years (including 10 years)
Patients who meet the diagnostic criteria for Parkinson’s syndrome in step 1, but do not have any of the criteria in step 2, and meet three or more of the criteria in step 3, are clinically diagnosed with Parkinson’s disease.