Diagnosis of Parkinson's Disease
Parkinson’s is a chronic neurodegenerative disease that in older adults can be confused with signs of aging itself or with other origins of hand tremor. For this reason, it isn’t always easy to detect and the diagnosis of Parkinson’s disease can be delayed.
The tremor that appears despite a person being relaxed and at rest is one of the symptoms that’s most associated with the pathology. It’s also one of the most characteristic. However, we should note that not all patients experience it. Therefore, the presence of tremors isn’t a sure guarantee that its origin is Parkinson’s.
Self-evaluation is essential in the diagnosis of Parkinson’s disease. It allows you to obtain a lot of information that can help to clarify the situation as the physical examination and the first talk in the doctor’s office are carried out.
When doing the self-evaluation, it’s important to know the symptoms of Parkinson’s disease and understand that these aren’t exclusive to the disorder; they can also occur in other conditions. This means that the fact you perceive or suspect one or more signs isn’t confirmation as such.
The symptoms that are most often taken into account are the following:
- Muscular stiffness
- Slowness when moving
- Reduced facial expressions
- Decreased sense of smell
- Shuffling while walking
- Restless legs syndrome
- Tremor when at rest
- Difficulties moving around and performing certain activities (putting on and taking off clothes, writing)
- Difficulty maintaining balance and posture
- Drops in blood pressure when standing up or making other changes in posture
It may be a good idea to keep a record of your symptoms and discuss them in more detail with your doctor later. In doing so, you need to write down how often they occur, how much they affected your routine, and what you think triggered the discomfort.
Tests for the diagnosis of Parkinson’s disease
There’s no specific single test that allows a direct diagnosis of Parkinson’s disease. This means that it can’t be detected by a blood, urine, or cerebrospinal fluid test, as well as an imaging test.
We hope that, in the future, researchers will be able to detect a biomarker that will facilitate direct diagnosis. However, for the time being, we have to use what’s available.
The Michael J. Fox Foundation explains to us that the diagnosis is made from the patient’s symptoms, their history, the answers to certain questions, and the findings found in the check-up. The experience and knowledge of the specialist play a key role in this. For this reason, they recommend consulting a specialist in movement disorders or a neurologist with specialized training in Parkinson’s.
On the other hand, the MSD Manual points out that when Parkinson’s disease isn’t certain, the doctor may prescribe a drug called levodopa. If the person shows a clear improvement after taking it, then the diagnosis is that they have Parkinson’s.
Some of the imaging tests that the doctor may prescribe to confirm or rule out the diagnosis of Parkinson’s disease are the following:
- Computed tomography
- Nuclear magnetic resonance
- Single-photon tomography (SPECT)
- Positron emission tomography (PET) scan
The first two tests allow us to detect if the symptoms experienced by the person are the consequence of a structural disorder or if it’s Parkinson’s. The other two types of CT scans detect brain abnormalities which are typical of the disease and parkinsonism.
Differential diagnosis of Parkinson’s disease
To reach a diagnosis of Parkinson’s disease, the doctor must rule out other health problems that have similar symptoms:
- Essential tremor
- Dystonic tremor
- Multisystemic atrophy
- Consumption of certain medications (antipsychotics, antidepressants, antiepileptics, antiemetics, and calcium channel blockers)
- Exposure to toxins (pesticides, carbon monoxide)
The diagnosis of Parkinson’s disease isn’t usually quick
The diagnosis of Parkinson’s disease may take a little longer than expected when the disease is in its early stages. This is why you need to be patient throughout the process.
Even though the diagnosis of this type of condition may take a little longer than usual, this doesn’t always mean that the wait will be very long. It all depends on the case.
While awaiting the diagnosis, it isn’t advisable to ignore your discomfort though. It’s preferable to discuss your situation with a specialist and maintain good communication with them to receive the necessary assistance.
- Conoce la enfermedad – Federación Española de Parkinson [Internet]. [cited 2021 Jul 5]. Available from: https://www.esparkinson.es/espacio-parkinson/conocer-la-enfermedad/
- Gonzalez-Usigli H. Enfermedad de Parkinson – Enfermedades cerebrales, medulares y nerviosas [Internet]. Manual MSD versión para público general. 2020 [cited 2021 Jul 5]. Available from: https://www.msdmanuals.com/es/hogar/enfermedades-cerebrales,-medulares-y-nerviosas/trastornos-del-movimiento/enfermedad-de-parkinson
- Recursos en Español | Parkinson’s Disease [Internet]. The Michael J. Fox Foundation for Parkinson’s researchers. [cited 2021 Jul 5]. Available from: https://www.michaeljfox.org/recursos-en-espanol