During outpatient visits, patients often ask: Doctor, is this my disease Parkinson’s disease? So, how do we doctors diagnose Parkinson’s disease? Please listen to me slowly. The diagnostic criteria used in our textbooks and related literature have been the British Parkinson’s Brain Bank diagnostic criteria, which have been in use since 1997. Clinically, the British Parkinson’s Brain Bank diagnostic criteria, which has been in use for almost 20 years, has faced many challenges as the diagnosis and understanding of the disease has evolved and knowledge of the disease has increased. This year (2015), the Movement Disorders Society (MDS) has developed new diagnostic criteria based on the UK’s Parkinson’s Brain Bank diagnostic criteria. This criteria is green compared to the UK’s Parkinson’s Brain Bank diagnostic criteria and is a very important guide for clinicians. These guiding documents in medicine are still difficult to read and understand in their entirety, even for physicians who do not specialize in this specialty, and even more obscure and confusing for most patients and their families. Here, I will try to explain the diagnosis of this disease as simple and accurate as possible, so that everyone will know at a glance whether they have Parkinson’s disease. 1, the vast majority of groups affected are middle-aged and elderly, the average age of onset in China is 55 years old, mostly seen after the age of 60, patients under 40 years old are relatively rare. But there are exceptions, there are very few patients are young Parkinson’s disease patients, these patients generally have a family history. The disease usually starts unilaterally, progresses slowly, and dopamine-like drugs (medroxyprogesterone) are effective. Many patients start with tremor or stiffness in one upper or lower extremity, for example: some patients say that my left upper arm swings much less than the right when I walk; some patients say that my left hand is shaking when I am not paying attention, and as soon as I focus on my left hand, the shaking stops. These symptoms get progressively worse and gradually involve the contralateral limb. These symptoms are significant in the early and middle stages of the disease with Medroba, where the patient feels that the limb is not stiff and the shaking has stopped half an hour to an hour after taking the medication. However, because this is a slowly progressive disease, in the later stages the symptoms worsen, the efficacy of the drug diminishes, and drug-related complications, such as fluctuating symptoms and switching phenomena, can occur. This complication will be slowly explained in a later article. 2. The most significant symptom of Parkinson’s disease is reduced or delayed movement. In the early stages, fine movements such as tying shoelaces and buttons move slowly, gradually progressing to a generalized slowing of movements, leading to difficulties in turning over and getting up. For example, if the patient is told to make a fist, after repeated several times, the movements become slower and smaller in amplitude. For example, if the patient is standing on the ground and wants to walk out, but his feet seem to be frozen or tied up, he cannot step out, but if his family members give him a hand, he can slowly start walking. The facial expression muscles can also be affected, and these patients have a stiff facial expression, medically known as a “mask face”. Decreased movement is an essential part of the diagnosis of Parkinson’s disease. 3. Resting tremor. Resting tremor is the most common first symptom, mostly starting at the distal end of one upper extremity, appearing or apparent at rest, stopping or decreasing with active movement, aggravated by stress or anxiety, and disappearing after falling asleep. Some patients do not have resting tremor. 4, muscle ankylosis. For the patient himself, the most intuitive feeling is unilateral or bilateral limb stiffness and inability to move. The doctor’s experience during physical examination is leadpipe-like ankylosis (passive movement of the joint is increased resistance, consistent) or gear-like ankylosis (seen in patients with tremor, passive movement of the limb is resistance intermittently appear). Also, the province’s muscle ankylosis appears in a specific flexion posture, as shown by: head forward, trunk prone flexion, elbow flexion, knee hip flexion. 5. Non-motor symptoms. Instead of motor symptoms such as tremor and tonicity, some patients start with non-motor symptoms such as hyposmia at the beginning. In addition to hyposmia, it is also seen in: sleep disorders, constipation, urinary disorders, postural hypotension, excessive sweating, increased facial oil, and even psychiatric symptoms such as depression, anxiety, and hallucinations. These are the main manifestations of Parkinson’s disease. If a patient has most of these manifestations, the diagnosis of Parkinson’s disease is eight or nine. Parkinson’s disease has no positive findings in all the most advanced tests including CT and MRI (if there is a positive finding, it is likely not Parkinson’s disease), so how can a patient be diagnosed rigorously? To give a diagnosis to a patient is to label a person, and must be rigorous and careful! The first step is to diagnose Parkinson’s syndrome. This is when patients ask, “What is the difference between Parkinson’s disease and Parkinson’s syndrome? They all seem to be the same. Let’s put it this way: Parkinson’s syndrome is like a big basket that includes Parkinson’s disease and many other diseases with symptoms similar to Parkinson’s disease. We need to pick out Parkinson’s disease from this basket. So, how do we pick it out? To diagnose Parkinson’s syndrome, first, you must have motor retardation, and second, you must have either myotonicity or resting tremor. The diagnosis of Parkinson’s syndrome can be established. The second step, how to diagnose Parkinson’s disease? We still need to slowly sift through this basket. If there is also: unilateral onset, slow progression of the disease, significant effect of dopamine drugs (Medrobac), and a clinical course of more than 5 years. With these characteristics, then the diagnosis of Parkinson’s disease is basically established. But there is still some work to be done to make a rigorous diagnosis. However, that’s the doctor’s job to do. Once you suspect Parkinson’s disease, then rush to the hospital, find a doctor who specializes in Parkinson’s disease, and choose the right treatment plan according to the doctor’s opinion.