Diagnosing Parkinson's

 Diagnosing Parkinson's can be difficult. With no test available to diagnose Parkinson's early signs, observation over time is often necessary.

-The neurologist will also need a  complete medical history , as well as a list of all  current medications  taken.

 Next, a thorough neurological exam is necessary.

-An evaluation of the coordination, walking motion and simple hand movements of the individual is recorded.

Possible MRI or CT scans may be used under certain conditions, or if the patient is young. These may also help to rule out other disorders .

  Dopamine and Other Considerations

 How an individual responds to  dopamine  medications, and if a significant improvement in symptoms is seen while taking these medications,  this  may lead to the Parkinson's diagnosis.

-It's also important in diagnosing Parkinson's that there are at least 2 of the following primary symptoms present to consider a Parkinson's diagnosis:

 - Bradykinesia:  slowness of movement.

 - Tremor: Shaking  (more pronounced at rest).

 - Rigidity:  Stiffness of the body, arms or legs.

 - Balance  and coordination problems. (postural instability)

 -Complete list of symptoms

 A Tremor Symptom occurring on one side, while at rest (or resting tremor) is the most common presentation in Parkinson's diagnosis.

Parkinsonism:  Means that a person has signs  similar  to Parkinson's symptoms, but the symptoms may  not  be due to the degeneration of dopamine in the brain.

- About 15% of those with Parkinson's symptoms  do not  have the disease .

  Other Possible Diagnoses with Parkinson's Symptoms:

-Brain Tumor:  Depending on the location of the tumor, can cause many of the same symptoms of Parkinsons.

-Head Trauma:  Due to a serious automobile or other accident or fall may result in a Parkinson's diagnosis.

-Wilson's Disease:  A genetic disorder that has some Parkinson's symptoms, may exhibit tremors, liver dysfunction

-Progressive Supranuclear Palsy:  Disorder with Parkinson's features in addition to abnormal eye movements and dementia.

-Shy-Drager Syndrome: 
Disorder with Parkinsonian features, also displays very low blood pressure when standing up (severe postural hypotension)


-Multiple Strokes:  Located in the similar regions of the brain often associated with the Parkinson's signs.

-Side Effects of Medications:  Some anti-nausea and anti-psychotic medications may cause similar symptoms.

- Normal Pressure Hydrocephalus  (NPH): 
Fluid inside the brain that does not drain properly, which can result in loss of bladder control, slower thinking, and difficulty in walking.

-Essential Tremor (ET):  Diagnosing Parkinson's, a  resting tremor  is a common symptom. This symptom is also present at times in essential tremor. It may start at any age, but is more common in the elderly and usually affects both hands rather than just one side.

Essential tremor often includes a shaky characteristic in speech, as well as head tremors.

Research shows ET may possibly be a precursor in diagnosing Parkinson's or may be a risk factor  for  Parkinson's, as those with Essential Tremor have about a 4 times greater likelihood of a Parkinson's diagnosis.


Parkinson's Sub-Types - Stages of Parkinson's - Parkinson's Prognosis         ______________________________________________________________

  Tremor Dominant: 

 This is the most common type of Parkinson's diagnosis. Encompassing 75% of the cases seen. It usually starts with a slight hand tremor on one side only. It is also the most treatable with the  best prognosis .

-PIGD  ( P artial  I nstability  G ait  D ifficulty): Less common type, often begins with a shuffling gait, progresses to balance difficulties and falling.

 PIGD progresses rapidly, and often  does not  respond well to Levodopa; As a result, the prognosis for this type is not as favorable as with the tremor dominant type.

-It usually occurs with late onset Parkinson's disease.


 By Age of Onset:

Juvenile Parkinsons:  As young as childhood, in extremely rare form.

-Young onset:  Diagnosed in the 20's or 30's, usually tremor dominant.

-Late Onset: 
More likely to be PIGD type with gait difficulties and balance problems early on (possibly cognitive), with dementia in the advanced stages. 


   5 Stages of Parkinson's

 -Stage 1:  Symptoms typically appear, usually a tremor on 1 side only.

 -Stage 2:  The Parkinson's symptoms spread to both sides, balance and coordination is still fine.

 -Stage 3:  Mild to moderate stages , progression to problems with balance, but still functionally independent.

 -Stage 4:  Severely disabled, the person will need assistance at this Parkinsons stage, but can still walk and stand independently.

 -Stage 5: 
At stage 5, the patient is bedridden or confined to a wheelchair.


   Parkinson's Forecast

 Most people receiving a Parkinson's diagnosis are of the tremor dominant type, and this type responds well to Levodopa, although this varies for each individual.

-How long medications continue to relieve symptoms also varies, and the side effects of medications can also be quite severe for some over time.

 Undetected and untreated , Parkinsons can leave a person totally disabled, and could lead to a deterioration of all brain functions, and an early death as a result.

-In the later stages of Parkinson's, complications from falls, choking, pneumonia, and various infections may lead to death.

 Overall, life expectancy with Parkinson's disease is actually only slightly less than normal, with generally a better prognosis, the later in life in diagnosing Parkinson's.

  Parkinson's progresses at much different rates for different people.

-It can be very difficult to predict the stages of Parkinsons for any given person; the progression may take over 20 years for one, and advance more quickly for another.

 can handwriting diagnose Parkinsons?

  The Good News:

As demonstrated by Michael J. Fox, many can continue very productive lives for many years with treatment. (see  video  on treatments page.)

 And, for those who remain involved in current activities, as well as with an eye toward the future, it truly appears to progress more slowly.

 - A positive mental attitude and outlook can definitely go a long way!


back to  Symptoms of Parkinson's 

-Additional Information on Parkinsons and Your Health...

Symptoms of Parkinsons - Treatments for Parkinsons - Alzheimers Warning Signs

Diabetes Story - Your Stories - Alzheimers or NPH? - Diagnosing Alzheimers

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-More on Parkinson's:

   What is Parkinson's?

   Symptoms of Parkinson's

   The 5 Stages

   Other Possible Diagnoses

   Parkinson's Medications

   Therapy and Exercise

   Surgery Options

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