Parkinson's disease
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How do doctors diagnose Parkinson's disease?

There is no test that can tell you whether you have Parkinson's. To diagnose the disease, your doctor will probably:

  • Ask about your symptoms and your health now and in the past
  • Examine you to see whether something else could be causing your symptoms.
If you are young, your doctor may do some blood tests to rule out other, rarer diseases.

If your primary care doctor thinks you may have Parkinson's disease, they should refer you to a specialist (this doctor could be a geriatrician or a neurologist).

The specialist may recommend you have a brain scan, such as an
 
 
 
 
 
MRI scan
The magnetic resonance imaging (MRI) machine uses a magnetic field to create detailed pictures of the inside of the body. These pictures allow doctors to look at parts of the body in three-dimensional images.
 
 
 
 
 
MRI. Scans provide images of the inside of your brain to help your doctor rule out other problems or diseases.
 
 
 
 
 
Source:
Lang AE, Lozano AM.
Parkinson's disease.
New England Journal of Medicine. 1998; 339: 1044-1053.
 
 
 
 
 
1
 
 
 
 
 
Source:
Langston JW, Widner H, Goetz CG, et al.
Core assessment program for intracerebral transplantations (CAPIT).
Movement Disorders. 1992; 7: 2-13.
 
 
 
 
 
2 Different types of brain scan give different information.

MRI scans
These use magnetism to take pictures of your brain. They are good at showing up damaged areas of your brain. The results of these scans can help doctors decide if you have Parkinson's or if your symptoms are because of something else (like a stroke, for example). You lie still inside the scanner. It looks like a large tube and is quite noisy. Tell the staff if you don't like enclosed spaces, as they can help you. For example, they may give you a panic button to hold in your hand during the scan. If you're feeling too panicky to stay in the scanner, you press the button and the staff will let you out.

PET (Positron Emission Tomography)
These scans use injections of radioactive chemicals to show how well different parts of your brain are working. They can help doctors tell if you have Parkinson's or another brain disease. Having a PET scan doesn't hurt. You'll have a small injection and then wait for the radioactive chemical to get to your brain. You'll then be asked to lie very still in the scanning machine while the pictures are taken. You will only be exposed to a very small amount of radioactivity, and it doesn't last long. So it isn't dangerous.
 
 
 
 
 
Source:
Parkinson's Disease Society.
Diagnosis and scans. Information sheet FS48.
August 2006. Available at http://www.parkinsons.org.uk/pdf/is_fs48_Datscan_06.pdf (accessed 2 April 2009).
 
 
 
 
 
3

SPECT (Single Photon Emission Tomography)
These scans are very similar to PET, but they use different radioactive substances.
 
 
 
 
 
Source:
Parkinson's Disease Society.
Diagnosis and scans. Information sheet FS48.
August 2006. Available at http://www.parkinsons.org.uk/pdf/is_fs48_Datscan_06.pdf (accessed 2 April 2009).
 
 
 
 
 
3 Like PET scans, they can help doctors decide if you have Parkinson's or something else.

To be diagnosed with Parkinson's disease, you should have at least two of the following three symptoms:
 
 
 
 
 
Source:
Marjama-Lyons JM, Koller WC.
Parkinson's disease: update in diagnosis and symptom management.
Geriatrics. 2001; 56: 24-25.
 
 
 
 
 
4

  • Shaking (tremor)
  • Stiff muscles (rigidity)
  • Slow movement (bradykinesia).
Poor balance is also a symptom of Parkinson's, but this usually happens in the later stages of the disease. To learn more about symptoms, see What are the symptoms of Parkinson's disease?

Diagnosing Parkinson's in the early stages can be difficult. But it's important to get the right diagnosis. There are many illnesses with symptoms similar to those of Parkinson's, and they are treated differently. See Diseases that look like Parkinson's to learn more.

You probably don't have Parkinson's if:
 
 
 
 
 
Source:
Parkinson's Disease Society.
Diagnosis and scans. Information sheet FS48.
August 2006. Available at http://www.parkinsons.org.uk/pdf/is_fs48_Datscan_06.pdf (accessed 2 April 2009).
 
 
 
 
 
3

  • Your symptoms don't get any better when you start taking medication for Parkinson's, such as levodopa (often called L-dopa) or a dopamine agonist
  • Your movement problems affect both sides of your body in the same way (they are symmetrical)
  • Your symptoms get worse quickly
  • You have problems with your memory, thinking or personality early on or before other symptoms start.

Sources for the information on this page:
  1. Lang AE, Lozano AM.Parkinson's disease.New England Journal of Medicine. 1998; 339: 1044-1053.
  2. Langston JW, Widner H, Goetz CG, et al.Core assessment program for intracerebral transplantations (CAPIT).Movement Disorders. 1992; 7: 2-13.
  3. Parkinson's Disease Society.Diagnosis and scans. Information sheet FS48.August 2006. Available at http://www.parkinsons.org.uk/pdf/is_fs48_Datscan_06.pdf (accessed 2 April 2009).
  4. Marjama-Lyons JM, Koller WC.Parkinson's disease: update in diagnosis and symptom management.Geriatrics. 2001; 56: 24-25.
This information was last updated on Apr 14, 2009
BMJ Group
This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.
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