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Making an accurate diagnosis of Parkinson’s — particularly in its early stages — is difficult, but a skilled practitioner can come to a reasoned conclusion that it is PD. You may have experienced this frustration. Perhaps it took years for you to receive a diagnosis. Perhaps you have been diagnosed, but with Parkinsonism, not Parkinson's, and are confused about the implications.
How is Parkinson’s Diagnosed?
Often, the diagnosis of Parkinson’s is first made by an internist or family physician. Many people seek an additional opinion from a neurologist with experience and specific training in the assessment and treatment of Parkinson’s disease — referred to as a movement disorder specialist.
To diagnose Parkinson’s, the physician takes a careful neurological history and performs an examination. There are no standard diagnostic tests for Parkinson’s, so the diagnosis rests on the clinical information provided by the person with Parkinson’s and the findings of the neurological exam.
- The doctor looks to see if your expression is animated.
- Your arms are observed for tremor, which is present either when they are at rest, or extended.
- Is there stiffness in your limbs or neck?
- Can you rise from a chair easily?
- Do you walk normally or with short steps, and do your arms swing symmetrically? The doctor will pull you backwards.
- How quickly are you able to regain your balance?
The main role of any additional testing is to exclude other diseases that imitate Parkinson’s disease, such as stroke or hydrocephalus. Very mild cases of PD can be difficult to confirm, even by an experienced neurologist. This is in part because there are many neurological conditions that mimic the appearance of Parkinson’s.
A person’s good response to levodopa (which temporarily restores dopamine action in the brain) may support the diagnosis. But this is not relevant if your doctor thinks you do not need any medication at this time. If you are in doubt of your diagnosis or if you need further information, you may want to seek a second opinion.
PDF recommends that a person with symptoms resembling those of PD consider making an appointment with a movement disorder specialist. To find a specialist in your community, call PDF's HelpLine at (800) 457-6676 from Monday to Friday, 9:00AM ET to 5:00 PM ET and our staff can help you locate one.
Why Aren’t There Tests to Diagnose Parkinson’s?
There is no standard diagnostic test for Parkinson’s. Researchers are working to develop an accurate “biological marker,” such as a blood test or an imaging scan. To date, the best objective testing for PD consists of specialized brain scanning techniques that can measure the dopamine system and brain metabolism. But these tests are performed only in specialized imaging centers and can be very expensive.
Do you have more questions about your diagnosis? Email us your questions directly or call our helpline at (800) 457-6676.