1. What is the “end-of-dose phenomenon”? The “end-of-dose phenomenon” refers to the deterioration of Parkinson’s disease symptoms at the end of each dose as the duration of drug effect becomes shorter and shorter. Treatment: Increase the number of doses of levodopa, and use Parkinson’s controlled-release tablets, dopamine agonists, silymarin, and COMT inhibitors to improve symptoms. 2.What is “morning stiffness”? “Morning stiffness” or “morning movement inability”, the patient shows that the symptoms are aggravated when waking up in the morning, and it is difficult to move around, and the symptoms disappear only after taking the drug for a period of time. In fact, this is also a kind of “end-of-dose phenomenon”, which is mainly caused by the long night time and insufficient drug storage in the central nervous system. In order to overcome this phenomenon, you can switch from taking levodopa at the latest time of the day to using Xanax controlled-release tablets, which not only helps to reduce the “morning stiffness”, but also helps patients to turn over at night. For patients with poor results, Xelianxing can be added, which has a long half-life and a long-lasting effect in the body and is effective in reducing morning stiffness. However, some patients have to use less medication at night because it affects their sleep more. For such patients, they can consider taking the first levodopa preparation half an hour before waking up and wait for the medication to take effect before waking up. Or take a fast-acting levodopa preparation – “Medopa Fast”, which has good effect. 3.What is the “on-off” phenomenon? Some patients who take levodopa later experience fluctuations in symptoms, and when the drug takes effect, they can return to the functional state of a normal person, and after the effect of the drug, symptoms of Parkinson’s disease appear again, such as patients suddenly appearing muscle rigidity, tremor, and inability to move, which lasts for several minutes to an hour and then relieves. This can occur repeatedly and rapidly alternating multiple times throughout the day. The rate of change can be very rapid and unpredictable. Patients describe the changes as being like the power going on and off, so this phenomenon is clinically referred to as the “on/off phenomenon”. This is one of the worse complications of late levodopa treatment, and the mechanism is not well understood. The use of dopamine agonists and propargyl amphetamine can improve the symptoms, and if necessary, under the guidance and supervision of a doctor, levodopa can be gradually stopped for a period of time, and levodopa “holiday therapy” can be implemented, and then levodopa can be used again to reduce the “switch” phenomenon. The phenomenon of “switching” can be reduced. However, some experts think that the effect of holiday therapy is not ideal and should not be tried as a last resort. 4.What is “hyperkinetic disorder” and what are its manifestations? The “ochronosis” is a dance-like, tachycardia-like or simple repetitive involuntary movements, commonly in the facial muscles, the neck, back and limbs can also appear. In severe cases, the involuntary movements can be very large and can last for the entire onset of levodopa. When xerostomia occurs, it is often a sign of a high dose of the drug. If the involuntary movements are only mild and the reduction in medication makes the condition worse, the original treatment can be maintained. If the dyskinesia is significant, the amount of dopamine drugs and the application of dopamine agonists can be reduced appropriately, and dopamine receptor blockers such as Tebretol or haloperidol can be used if necessary. If the anisocoria is severe and affects self-care, and cannot be resolved with medication adjustments, surgical treatment may be considered. Pallidotomy is very effective for heterotaxy, but in a patient with severe symptoms bilaterally, the risk of swallowing or speech disorders is relatively high for bilateral surgery, whether staged or concurrent. Therefore, surgical treatment is often a last resort and should be treated with caution, especially for younger patients.