Step 1

Identification <ul><li>Bradykinesia</li><li>Plus one of:<ul><li>Rigidity</li><li>Rest tremor (4-6 Hz)</li><li>Postural instability (non-sensory/ccerebeliar)</li></ul></li></ul>

Step 2

Exclusion Criteria<ul style="margin-top: 4px; margin-bottom: 0; padding-left: 20px; font-size: 14px;"><li>Strokes or head injury</li><li>Dopamine-blocking drugs</li><li>Poor/absent levodopa response</li><li>Early severe cognitive (neurological signs)</li></ul>

Step 3

Supportive Criteria<ul><li>Uniateral onset</li><li>Rest tremor</li><li>Excellent levodopa response</li><li>Levodopa benefit &gt;5 years</li><li>Severe levodopa-induced dyskinesia</li><li>Persistent asymmetry</li><li>Disease duration</li></ul>

If criteria are not met → Parkinson’s disease unlikely

If any exclusion criteria are identified → Diagnosis of Parkinson’s disease is unlikely.

If no exclusion criteria are identified → Proceed to Step 3 for supportive diagnostic features.

If ≥3 supportive criteria present → Diagnosis: Definite Parkinson’s disease

If &lt;3 supportive criteria present → Possible Parkinson’s disease

If criteria met - procceed to Step 2

a.x,