Parkinson's disease Braak staging

Written by Liu Hong Mei
Neurology
Updated on April 02, 2025
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Parkinson's disease Braak staging is generally divided into five stages:

Stage 1 refers to unilateral symptoms only, such as tremors or stiffness in one hand or one foot, with symptoms confined to one side of the body and not crossing the midline.

Stage 2 refers to mild symptoms on both sides, such as tremors in both hands or throughout the body, but without impairment of balance.

Stage 3 refers to more pronounced bilateral symptoms, such as difficulty lifting legs, taking small shuffling steps, leaning forward, or instability when holding a bowl while eating, but capable of living normally.

Stage 4 refers to the loss of most of the ability for autonomous activity.

Stage 5 refers to a complete loss of the ability to live independently.

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Written by Zhang Hui
Neurology
1min 7sec home-news-image

How does one get Parkinson's disease?

Parkinson's disease is a degenerative disease of the nervous system. The actual mechanism of the disease is not very clear, and its fundamental cause has not yet been identified. It is generally believed that Parkinson's disease is mainly caused by the following factors. First, genetic factors. Some cases of Parkinson's disease have a clear familial tendency, where patients may experience mutations in synaptic nuclear protein genes, leading to abnormal aggregation of these proteins. This abnormal aggregation can damage the neurons in the substantia nigra of the midbrain, leading to Parkinson's disease. Second, there are some external factors related to sporadic cases of Parkinson's. These may be closely related to oxidative stress, trauma, poisoning, or an excessive stress response of the body. However, the specific cause is not very clear. Parkinson's disease, which causes symptoms such as bradykinesia, tremors, and rigidity, requires active treatment to improve the quality of life of the patients.

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Neurology
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Early symptoms of Parkinson's disease.

Parkinson's disease is a relatively common degenerative disease in the elderly, primarily causing the death of dopamine neurons in the substantia nigra of the midbrain, leading to corresponding clinical manifestations. Research has confirmed that other systems may also be damaged in the early stages of Parkinson's disease symptoms. The early symptoms may primarily include: First, patients experience persistent constipation, which is a very important early symptom of Parkinson's disease. Second, some patients may experience sleep disturbances, mainly characterized by tossing and turning, shouting out loud during sleep, without being aware of it. Additionally, some patients in the early stages may also experience a reduced sense of smell, constipation, cognitive impairment, and other clinical manifestations. There are also some early motor symptoms, mainly that the patient becomes clumsy and inflexible in the movements of one side of the body. These are the early symptoms of Parkinson's disease.

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Neurology
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Can Parkinson's patients drink alcohol?

It is recommended that patients with Parkinson's disease avoid drinking alcohol. This is because the condition in Parkinson's patients is caused by the death of certain neurons in the substantia nigra of the midbrain. It is well-known that alcohol has a direct damaging effect on neurons. Therefore, drinking alcohol could potentially worsen the symptoms of Parkinson's disease, and it is advised not to drink alcohol. Additionally, patients with Parkinson's disease are prone to panic and unstable gait. If alcohol consumption affects the function of the cerebellum, it will exacerbate the patient's instability in walking, making them very prone to falls and potentially causing complications such as fractures. Furthermore, drinking alcohol can lead to orthostatic hypotension, which is a lower blood pressure when standing up. Parkinson's disease itself can also cause this type of orthostatic hypotension, and the combination of the two can cause a significant drop in blood pressure in patients, posing a risk when standing.

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Geriatrics
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Can Parkinson's disease be cured?

The core treatment for Parkinson's disease currently is pharmacotherapy, with surgical treatment serving as a supplement. Additionally, physical rehabilitation and psychological therapy are also recommended. The most effective drugs against Parkinson's at present include Levodopa, or compound Levodopa preparations. Other treatments include dopamine receptor agonists, monoamine oxidase inhibitors, amantadine, anticholinergic drugs, and catechol-O-methyl transferase inhibitors. Furthermore, there are treatments aimed at non-motor symptoms, such as psychiatric symptoms, cognitive impairments, autonomic dysfunctions, and sleep disorders. For drug treatments, it is advisable to start with a low dose and gradually increase to an appropriate dosage while maintaining the medication regimen. Currently, we cannot cure Parkinson's disease; we can only provide relief to the symptoms and slow the progression of the disease through comprehensive treatment. (The use of medications should be under the guidance of a doctor.)

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Neurology
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How long can someone with Parkinson's disease live?

Parkinson's disease is a degenerative disease of the nervous system. It has a slow and inconspicuous onset, and it progresses gradually. The disease itself does not affect the patient's lifespan, as it does not impact the functions of heartbeats or breathing. If treated properly, cared for promptly, medications are taken as prescribed by the doctor, and followed up long-term, patients can survive about twenty years without problems. However, if patients adjust their medications on their own, stop taking their medications without consultation, or receive improper care from family members leading to accidental injuries or complications such as lung infections, then their lifespan can be significantly shortened. Once bedridden, life expectancy may rapidly decline. Therefore, with proper treatment and care, patients with Parkinson's disease can survive for about ten to twenty years. If care and treatment are not managed properly, patients may be threatened by fractures or lung infections, potentially reducing their lifespan to about five to ten years.