Parkinson’s disease (PD), also known as tremor palsy, is the second common neurodegenerative disease after dementia, with a prevalence of about 1.7% in people over 65 years of age in China, and currently, there are more than 20 million patients with PD in China. The pathogenesis of the disease Dopamine and acetylcholine are two important neurotransmitters in the striatum, and they antagonize each other and maintain the balance. In Parkinson’s disease, dopaminergic neurons in the substantia nigra of the midbrain are degenerated and absent, and cannot synthesize enough dopamine, resulting in a significant decrease (80%) in the amount of dopamine input to the striatum and a relatively hyperfunctional acetylcholine system, resulting in clinical symptoms of Parkinson’s disease. Clinical manifestations Early manifestations often include limb stiffness and tremor, with a slow onset and gradual progression. The disease often begins in one upper limb, then extends to the ipsilateral lower limb and then to the contralateral upper and lower limbs, progressing in an “N” shape. The common manifestations are: 1. Resting tremor: “pill-rolling” movement, frequency 4-6Hz, some elderly people (over 70 years old) do not have tremor, this point should be noted. 2.Myotonicity: increased muscle tone, “leadpipe like” “gear like” myotonicity. 3.Motion retardation: slow movement, reduced random movement, reduced facial expressions, “mask face”, inability to do fine movements, writing difficulties, writing curved, the smaller the writing, called “small writing syndrome”. 4, abnormal posture and gait: small steps, leaning forward, “panic gait”. 5. Other manifestations: slow speech, low intonation, drooling and difficulty in swallowing due to dyskinesia of the pharyngeal muscles. Phytodystrophy, intractable constipation, sweating, insomnia, upright hypotension, hypersecretion of sebaceous glands. Psychiatric symptoms, depression, hallucinations, and in severe cases, mental retardation. Parkinson’s three concepts: 1, Parkinson’s disease: no clear cause of the above clinical manifestations, mostly g-side onset, resting tremor is predominant, often no abnormal performance on cranial CT or MRI, dopamine therapy is effective and the prognosis is relatively good. 2, Parkinson’s syndrome: there are clear causes of the above clinical manifestations can be found, after various encephalitis, cerebrovascular disease, traumatic brain injury, brain tumors, antipsychotic drugs or dopamine depleting agents (such as haloperidol, fenadine, rifampin, gastropropion, chlorpromazine, flunarizine, methyldopa), poisoning or exposure to toxic substances (carbon monoxide poisoning, cyanide poisoning, manganese, mercury, MPTP, etc.). 3. Parkinson’s superimposed syndrome: In addition to the symptoms of Parkinson’s disease, the patient also shows multiple neurological involvement.