Parkinson’s disease occurs between the ages of 50 and 60, but there are many people younger than 40 years of age who start the disease. In China, there are significantly more men than women, with a ratio of 3:1. The main clinical manifestations of Parkinson’s disease are: resting tremor, myotonia, bradykinesia and balance disorders. 1, tremor: This is the first symptom of most Parkinson’s disease patients. It often starts on one side of the hand, and typically manifests as a “pill-rubbing” tremor. As the disease progresses, the tremor gradually spreads to the entire limb, and even affects the trunk and head and face. In the early stage of Parkinson’s disease, the resting tremor is fluctuating and disappears during sleep or anesthesia, and can be reduced or stopped by random movement; in the late stage of Parkinson’s disease, the tremor is not reduced or disappears during random movement. The tremor becomes more pronounced during emotional excitement, stress, and anxiety. Strong voluntary efforts can temporarily suppress the tremor, but it tends to increase afterwards. Zhao Chunsheng, Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University 2, muscle ankylosis: this is the term used by doctors to describe the increased tension of the patient’s muscles in a relaxed state, the doctor can feel the increased muscle tone in the patient’s joints for passive movement, always consistent, uniform resistance, similar to the feeling when bending a soft lead pipe, so called “lead pipe-like ankylosis “If the patient has tremor at the same time, the patient feels intermittent pauses in the uniform resistance, such as gear rotation, called “gear-like ankylosis”, the patient’s own feeling is a sense of muscle stiffness, the limb is very laborious, heavy and weak when moving. 3, slow movement: often the most disabling symptom of Parkinson’s disease patients, affecting many movements in daily life. Patients find it difficult to turn over and get up from a sitting position when they are bedridden. They have difficulty in tying shoelaces, buttoning, putting on and taking off shoes and socks, washing face, brushing teeth and shaving, etc. They have difficulty in completing these movements. Once you step, you will rush forward with a smaller pace, and the faster you rush, the faster you can’t stop, you can’t stop in time, and you have difficulty turning, which is called “panic gait”; facial expression muscles are affected, which is characterized by lack of expression, less transient eyes, staring with both eyes, and a “mask face”; the mouth is affected. “If the muscles of the mouth, tongue, palate, pharynx, and vocal cords are involved, it can be manifested as difficulty in swallowing, salivation, and low speech. Slurred speech, etc. 4, balance disorder: This is a serious problem for patients with Parkinson’s disease. It is also an important marker for grading Parkinson’s disease (the demarcation between HY grade II and grade III). Balance disorders can occur both early and late in the course of Parkinson’s disease, but there is a difference between the two. Balance impairment in early Parkinson’s disease occurs because of slow movement onset, making it difficult to maintain the body’s center of gravity, and can be corrected in this stage as well, since methyldopa or tranquilizer can significantly improve movement slowness. In the middle to late stages of Parkinson’s disease, the majority of patients will have balance difficulties. These patients may still be sensitive to anti-Parkinsonian accidents, but the balance disturbance cannot be corrected with medications, and the mechanism for this is not yet clear. Once this occurs, patients should use crutches or a walking frame to avoid falls. Other more minor clinical manifestations include salivation, excessive sweating, constipation, slurred speech, sleep disturbances, swallowing difficulties, depression, dyspnea, urinary urgency, and decreased sense of smell. It is important to note that clinical manifestations can vary greatly from patient to patient, and some patients may never develop tremor. The onset of Parkinson’s disease is insidious, and patients often cannot recall the exact time of onset. The disease usually starts in one upper extremity and gradually spreads to the ipsilateral lower extremity and the contralateral upper and lower extremity. The disease slowly worsens progressively after onset.