Diagnostic criteria for foot tremor due to Parkinson’s disease

  Tremor of the feet is one of the features of Parkinson’s disease. Parkinson’s disease, also known as idiopathic Parkinson’s disease (PD), or Parkinson’s disease, also known as paralysis agitans (shaking palsy), is a common neurodegenerative disease of the middle-aged and elderly, and is the most common extrapyramidal disease of the middle-aged and elderly. The prevalence is 1000 per 100,000 people over 65 years of age and increases with age, slightly more in men than in women. The main clinical features of the disease: resting tremor, slowed and reduced movements, increased muscle tone, and postural instability are the main characteristics.  Diagnostic criteria for foot tremor due to Parkinson’s disease: I. Decreased movement: Patients have a variety of active movements in daily life, such as dressing, buttoning, brushing teeth, washing face, tying shoelaces, etc. Movements are slow and reduced, often sitting still. The writing is too small, often getting smaller and smaller, called “writing too small sign”. When walking, the distance between the two steps is reduced, and the steps are small. Speech is low and monotonous, and later there may be swallowing difficulties, choking and coughing when eating, and even in the late stage, a nasal feeding tube is needed.  The typical tremor is in the distal part of the limb, usually starting with one hand, and as the disease progresses, the opposite limb, mouth, lips, jaw and tongue can also appear. The tremor in the affected limb is mainly caused by rhythmic contraction and relaxation of the antagonistic muscles 4-8 times/second. The tremor is most pronounced in the metacarpophalangeal joints and thumbs of the hands, with a so-called “pill-rolling” motion, which is one of the diagnostic criteria for Parkinson’s disease.  Postural abnormalities: Due to the straightening of the limbs, trunk and neck muscles, the patient has a special posture, standing with the head, neck and trunk leaning forward, knee joints slightly bent, the upper limbs with (or with) movement disappeared, the patient walks faster and faster, in a forward posture and can not suddenly stop, called “panic gait”. Some patients in a certain stage of the disease, due to lower limb extension, flexor dystonia, can not walk forward normally, but can walk backwards, think this is easier, this is Parkinson’s disease diagnostic criteria.  Fourth, other: urinary and faecal difficulties, sweating, seborrhea and upright hypotension and other symptoms of plant nervous disorders. However, the disease does not involve the rectum and bladder sphincter, and does not cause urinary and fecal incontinence. There is also depressed mood and low sexual desire. Intellectual and emotional responses are mostly normal, but occasionally there is dementia or psychiatric abnormalities, which are also diagnostic criteria for Parkinson’s disease.