1, post-encephalitis Parkinson’s syndrome: Parkinson’s syndrome due to lethargic encephalitis, as it is commonly referred to, has not been reported for nearly 70 years, and therefore post-encephalitis Parkinson’s syndrome due to this encephalitis has disappeared. In recent years, it has been reported that patients with viral encephalitis can have Parkinson’s-like symptoms, but the disease has obvious symptoms of infection and can be accompanied by symptoms of neurological damage such as cranial nerve palsy, limb paralysis, convulsions, coma, etc. Brain crest fluid can have a mild to moderate increase in cell count, increased protein, and decreased sugar. The Parkinson’s-like symptoms are relieved when the disease is in remission, which can be differentiated from Parkinson’s disease. 2, hepatomegaly: recessive hereditary disease, about 1/3 have family history, adolescent onset, may have extrapyramidal symptoms such as increased limb tone, tremor, mask-like face, twisting spasms. The disease is characterized by liver damage, decreased corneal K-F ring and serum copper blue protein. It can be differentiated from Parkinson’s disease. 3, idiopathic tremor: a dominant genetic disease, manifested as head, jaw, and
The frequency of tremor can be high or low, high frequency is very similar to hyperthyroidism; low frequency is very similar to Parkinson’s tremor. The disease does not have reduced movement, increased muscle tone, and postural reflex disorder, and disappears after drinking alcohol, and can be differentiated from primary Parkinson’s disease. 4, progressive supranuclear palsy: This disease also occurs in middle-aged and elderly people, clinical symptoms can have muscle tonicity, tremor and other extrapyramidal symptoms. However, this disease has prominent eye gaze disorder, muscle tonicity to the trunk is heavy, the limb muscle involvement is light and better maintain the flexibility of the limb, the neck extensor muscle tone increased resulting in cervical hyperextension and Parkinson’s disease cervical flexion is obviously different, can be distinguished from Parkinson’s disease. 5, Shy_Drager syndrome: Clinical symptoms often have extrapyramidal symptoms, but can be distinguished from Parkinson’s disease because of prominent vegetative symptoms, such as syncope, upright hypotension, sexual function and bladder dysfunction, and ineffective treatment with levodopa preparations. 6, drug Parkinson’s syndrome: overdose of reserpine, chlorpromazine, haloperidol and other antidepressants can cause extrapyramidal symptoms, because there is a clear history of drug use, and reduce after discontinuation of drugs can be distinguished. 7, benign tremor: refers to physiological tremor (not easily perceived by the naked eye) and functional tremor without organic brain lesions. Functional tremor includes: (1) physiological tremor enhancement (visible to the naked eye), mostly postural tremor, associated with enhanced adrenergic regulatory response; also seen in certain endocrine diseases, such as pheochromocytoma, hypoglycemia, hyperthyroidism; (2) cocaine and alcohol intoxication and side effects of some drugs. Hysterical tremor, mostly with psychogenic triggers, distraction can relieve the tremor. (3) Others: tremor that occurs during emotional stress and during fine motor movements. Benign tremor is clinically free of the characteristic manifestations of Parkinson’s disease such as myotonicity, reduced movement and postural abnormalities.