Neurology Edited by Professor Emeritus Desire' Dubounet, IMUNE

Disease staging of ParkinsonismStage IStage IIStage IIIUnilateral symptoms/signs with no or slight disabilityBilateral symptoms/signs, no postural disorderSlight to moderate disability; disordered posture with instability on turning orexternal dislodgment. Employability partially preserved 6ob dependent)Stage IVStage VFull-blown picture with severe disability. Standing and walking preservedPatient confined to wheel-chair or bed and dependent on help.Grading of disability in ParkinsonismIIIIIIBradykinesia of hands0·= normal1 = hint of slowing2 = moderate, micrographia3 = severe, obvious impairment of functionRigidity0 = none1 = slight2 = moderate3 = severe (even when treated)Posture0 = normal1 = head forward up to 12.5cm2 = head forward up to 15 cm; upper limbs flexed3 = head forward more than 15 cm; upper limbs flexed above hip levelIV Upper limb swinging (walking)0 = normal1 = one arm reduced2 = one arm immobile3 = both arms immobileVGait