• Diagnosis of Parkinson’s Disease

    There are no lab tests to definitively diagnose Parkinson’s disease . Your doctor will ask about your medical history and do a thorough physical exam.
    A neurological exam will include a range of tests to evaluate your strength, coordination, balance, and other aspects, such as:
    • Muscle tone
    • Rapid alternating movements
    • Gait, posture
    • Postural stability
    • Quickness and precision of movement
    • Observation of a tremor (during rest or activity)
    A mini-mental status test may be done. Activities of daily living may also be evaluated, such as dressing, cutting and eating food, swallowing, hygiene, walking, and falls.
    There are four symptoms that are considered "hallmarks" of Parkinson’s disease. These symptoms include:
    • Tremor while at rest
    • Rigidity
    • Slowness of movement (bradykinesia)
    • Postural instability
    Sometimes, not all of these hallmark symptoms are present. If that is the case, your doctor may examine you every few months to check on your symptoms.
    Other symptoms of Parkinson’s disease include:
    • Blank facial expression
    • Decreased eye blinking
    • Stooped posture
    • Depression
    • Sleep disturbances
    • Shuffling gait
    • Difficulty with initiating movement
    • Difficulty rising from a sitting position
    • Difficulties with activities of daily living
    • Voice changes
    • Swallowing and drooling difficulties
    • Changes in handwriting
    • Loss of smell
    If your doctor has questions about the cause of your symptoms, you may be given tests to try to eliminate the possibility of other disorders. These tests may include:
    Your doctor may also give you a trial of levodopa, a medicine that increases the amount of dopamine your brain produces. A positive response to this medicine may help to confirm the diagnosis.
    Your doctor may also have imaging tests done, such as:
    • PET scan —You will be given an injection of a substance that will make the pictures of your brain clearer. You will lie on a table, which will slowly move you through a ring-shaped scanner. This test may take about 30 minutes or longer.
    • SPECT scan—You will be given an injection of a substance that will make the pictures of your brain clearer. You will lie on a table, and a camera-like object will slowly rotate around you. This test may take about 90 minutes or longer. Your doctor may choose to use a specific type of scan, called DATscan, to evaluate your condition.

    References

    Parkinson disease. American Association of Neurological Surgeons website. Available at: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Parkinsons%20Disease.aspx . Updated 2005. Accessed August 22, 2012.

    Conn HF, Rakel RE. Conn’s Current Therapy 2002. 54th ed. Philadelphia, PA: WB Saunders Company; 2002.

    Parkinson Disease. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/parkinsons%5Fdisease/parkinsons%5Fdisease.htm . Accessed August 22, 2012.

    Obeso JA, et al. Missing pieces in the Parkinson’s disease puzzle. Nature Medicine . 2010;16(6):653-661.

    Parkinson's disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 6, 2012. Accessed August 22, 2012.

    Should I get a DaTscan or PET scan to confirm my diagnosis of Parkinson’s disease? National Parkinson Foundation website. Available at: http://www.parkinson.org/Patients/Patients---On-The-Blog/February-2011/Should-I-get-a-DaTscan-or-PET-scan-to-confirm-my-d . Updated February 1, 2011. Accessed August 22, 2012.

    Varrone A, Haldin C. New developments of dopaminergic imaging of Parkinsons disease. Q J Nucl Med Mol Imaging. 2012:56:68-82.

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