Hoehn & Yahr Staging for Parkinson's Disease
Original 1967 (and modified) staging of Parkinson's disease severity by motor symptoms and disability. Drives clinical decisions on therapy intensity and rehabilitation.
Score interpretation
→ Begin dopaminergic therapy when functionally indicated (levodopa first-line per NICE NG71). MDS-UPDRS to track. Annual driving assessment if motor signs prominent. Exercise (Tai Chi, dance) shown to slow progression.
→ Optimise levodopa with adjuncts (MAO-B / COMT inhibitor, dopamine agonist). Specialist PD nurse, physiotherapy, OT. Falls prevention. Screen for non-motor symptoms (sleep, mood, autonomic, cognition).
→ Consider device-assisted therapy: deep brain stimulation, apomorphine infusion, levodopa-carbidopa intestinal gel (NICE TA681). Carer assessment. Advance care planning.
→ Multidisciplinary specialist PD service. Address dysphagia (SLT, gastrostomy), dementia (rivastigmine), end-of-life planning. Hospice / palliative-care input.
Interpretation bands for the Hoehn-Yahr. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Ropinirole · Dopamine Agonist — Parkinson's Disease
- Entacapone · COMT Inhibitor — Parkinson's Disease
- Rasagiline · MAO-B Inhibitor — Parkinson's Disease
- Trihexyphenidyl · Anticholinergic — Parkinson's Disease / Dystonia
- Apomorphine · Dopamine Agonist — Parkinson's Disease Rescue / Continuous Infusion
- Selegiline · MAO-B Inhibitor — Parkinson's Disease
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.