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VNA of Care New England
by Carson-DeWitt R

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.
There are 4 hallmark symptoms of Parkinson’s disease, but these may not all be present. If that is the case, your doctor may examine you every few months to check on your symptoms.
Symptoms may include:
  • Tremor while at rest
  • Rigidity
  • Slowness of movement (bradykinesia)
  • Postural instability
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.
If the diagnosis is not clear, you may be given tests to try to eliminate the possibility of other conditions with similar symptoms. These tests may include:
  • Blood tests
  • Urine tests
Imaging tests may include:
Your doctor may also give you a trial of levodopa, a medication that increases the amount of dopamine your brain produces. A positive response to this medication may help to confirm the diagnosis.

References

NINDS Parkinson's disease information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/parkinsons%5Fdisease/parkinsons%5Fdisease.htm. Updated July 26, 2016. Accessed November 29, 2016.
Obeso JA, Rodriguez-Oroz MC, Goetz CG, et al. Missing pieces in the Parkinson’s disease puzzle. Nature Medicine. 2010;16(6):653-661.
Parkinson disease. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115172/Parkinson-disease. Updated November 14, 2016. Accessed November 29, 2016.
Parkinson disease. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/neurologic-disorders/movement-and-cerebellar-disorders/parkinson-disease. Updated September 2015. Accessed November 29, 2016.
Parkinson's disease. American Association of Neurological Surgeons website. Available at: http://www.aans.org/en/Patient%20Information/Conditions%20and%20Treatments/Parkinsons%20Disease.aspx. Accessed November 29, 2016.
Ravina B, Marek K, Eberly S, et al. Dopamine transporter imaging is associated with long-term outcomes in Parkinson's disease.. Mov Disord. 2012;27(11):1392-1397.
Varrone A, Haldin C. New developments of dopaminergic imaging of Parkinsons disease. Q J Nucl Med Mol Imaging. 2012:56(1):68-82.
9/3/2014 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T115172/Parkinson-disease: Wippold FJ, Cornelius RS, Broderick DF, et al. American College of Radiology (ACR) Appropriateness Criteria for dementia and movement disorders. Available at: https://acsearch.acr.org/docs/69360/Narrative. Updated 2014. Accessed September 3, 2014.

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