Diagnosis
As the disease slowly destroys nerve cells in the brain, the first
symptoms of Parkinson's appear. The four hallmark symptoms are tremor
(shaking) of the hands, arms, legs and face; slow movement
(bradykinesia); stiffness; and difficulty with balance and coordination.
The disease is different in each person. Some people may become completely disabled relatively quickly, while others have only minor symptoms and get worse very gradually. In general, the symptoms will progress until the person notices distinct changes in his or her ability to walk, talk and perform other everyday activities. In the later stages of the disease, people with Parkinson's can develop a shuffling walk, muffled speech, small and illegible handwriting, emotional changes (including depression), a blank stare, difficulty chewing and swallowing, and constipation.
No single test can identify Parkinson's disease. Usually diagnosing the condition is a matter of ruling out similar diseases with the same symptoms. The doctor will first take a thorough health history and do a neurological test. Blood tests and magnetic resonance imaging (MRI) scans can rule out other diseases. People with at least two of the four hallmark symptoms of Parkinson's disease, and who respond to the drug levodopa, are said to have the disease.
Doctors can stage the severity of the disease using the Hoehn and Yahr Staging and Unified Parkinson's Disease Rating Scale.
The Hoehn and Yahr scale helps doctors describe the severity of symptoms based on five stages:
The disease is different in each person. Some people may become completely disabled relatively quickly, while others have only minor symptoms and get worse very gradually. In general, the symptoms will progress until the person notices distinct changes in his or her ability to walk, talk and perform other everyday activities. In the later stages of the disease, people with Parkinson's can develop a shuffling walk, muffled speech, small and illegible handwriting, emotional changes (including depression), a blank stare, difficulty chewing and swallowing, and constipation.
No single test can identify Parkinson's disease. Usually diagnosing the condition is a matter of ruling out similar diseases with the same symptoms. The doctor will first take a thorough health history and do a neurological test. Blood tests and magnetic resonance imaging (MRI) scans can rule out other diseases. People with at least two of the four hallmark symptoms of Parkinson's disease, and who respond to the drug levodopa, are said to have the disease.
Doctors can stage the severity of the disease using the Hoehn and Yahr Staging and Unified Parkinson's Disease Rating Scale.
The Hoehn and Yahr scale helps doctors describe the severity of symptoms based on five stages:
- Stage 1 -- symptoms are only on one side of the body
- Stage 2 -- symptoms are on both sides of the body, but balance isn't impaired.
- Stage 3 -- there is some balance impairment and disability.
- Stage 4 -- disability is severe, but the person can still walk or stand without help.
- Stage 5 -- the person cannot stand or walk, and is wheelchair-bound or bedridden.
- Intellectual impairment, depression, motivation
- Activities of daily living (speech, swallowing, handwriting, cutting food, dressing, hygiene and walking)
- Motor skills (speech, facial expression, tremor, rigidity, posture and walk)
There's no precise test for Parkinson's disease. This article describes how doctors diagnose the condition.
For patients with Parkinson's disease (PD), a PET scan is used to assess activity and function of brain regions involved in movement.
CT, or computed tomography, uses X-rays and computers to produce images of inside the body including the brain. This test is used to look for signs of disease like Parkinson's in the body .
MRI, or magnetic resonance imaging, is a test that produces very clear pictures, or images, of the human body without the use of X-rays. Instead, MRI uses a large magnet, radio waves, and a computer to produce these images.
Your health care provider may be able to diagnose Parkinson's disease based on your symptoms and a physical examination. However, the symptoms can be difficult to assess, particularly in the elderly. They become more clear as the illness gets worse.
A doctor's examination may show:
- Difficulty starting or finishing voluntary movements
- Jerky, stiff movements
- Shaking (tremors)
- Changes in your heart rate
Reflexes should be normal.
Tests may be needed to rule out other disorders that cause similar symptoms.
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