How is Parkinson’s disease diagnosed?

The Parkinson’s Protocol™ By Jodi Knapp Parkinson’s disease cannot be eliminated completely but its symptoms can be reduced, damages can be repaired and its progression can be delayed considerably by using various simple and natural things. In this eBook, a natural program to treat Parkinson’s disease is provided online. it includes 12 easy steps to repair your body and reduce the symptoms of this disease. The creator of this program has divided into four segments to cover a complete plan to treat this disease along with improving your health and life by knowing everything about this health problem. The main focus of this program is on boosting the levels of hormone in your brain by making e a few easy changes in your lifestyle, diet, and thoughts

How is Parkinson’s disease diagnosed?

Parkinson’s disease (PD) is diagnosed through a combination of clinical evaluation, patient history, physical examination, and diagnostic tests to rule out other conditions. There is no single definitive test for Parkinson’s disease, making the diagnosis primarily clinical. Here is a detailed overview of how Parkinson’s disease is diagnosed:

Clinical Evaluation

Patient History:
- Symptom Onset and Progression: The doctor will ask about the onset and progression of symptoms, such as tremors, stiffness, slowness of movement (bradykinesia), and balance problems.
- Family History: Information about family history of Parkinson’s disease or other neurological disorders may be relevant.
- Medical History: The doctor will review the patient’s overall medical history, including past illnesses, medications, and any exposure to toxins.
Physical Examination:
- Motor Symptoms: The neurologist will perform a thorough neurological examination to assess the presence and severity of motor symptoms. Key aspects include:
  - Tremor: Observing for a resting tremor, which typically occurs when the limb is at rest.
  - Bradykinesia: Evaluating slowness of movement through tasks such as finger tapping, hand movements, and rapid alternating movements.
  - Rigidity: Checking for stiffness in the limbs and neck by moving the patient’s arms and legs.
  - Postural Instability: Testing balance and gait, often through the “pull test” where the doctor gently pulls the patient backward to see if they can maintain balance.
- Non-Motor Symptoms: Assessing non-motor symptoms such as mood changes, sleep disturbances, cognitive impairment, and autonomic dysfunction (e.g., blood pressure changes, urinary problems).

Diagnostic Criteria

UK Parkinson’s Disease Society Brain Bank Clinical Diagnostic Criteria:
- Step 1: Diagnosis of a parkinsonian syndrome requires bradykinesia plus at least one of the following: muscular rigidity, 4-6 Hz resting tremor, or postural instability not caused by primary visual, vestibular, cerebellar, or proprioceptive dysfunction.
- Step 2: Exclusion criteria for Parkinson’s disease include history of repeated strokes with stepwise progression of parkinsonian features, repeated head injury, antipsychotic or antiemetic medication use, definite encephalitis, cerebellar signs, early severe autonomic involvement, early severe dementia, Babinski sign, tumor or hydrocephalus evident on neuroimaging.
- Step 3: Supportive criteria for PD diagnosis include unilateral onset, rest tremor, progressive disorder, persistent asymmetry affecting the side of onset most, excellent response (70-100%) to levodopa, severe levodopa-induced chorea, levodopa response for 5 years or more, clinical course of 10 years or more.

Response to Medication

Levodopa Challenge Test:
- Description: Administering levodopa or a dopamine agonist to see if symptoms improve significantly.
- Significance: A positive response to these medications can support the diagnosis of Parkinson’s disease, as the condition typically responds well to dopaminergic treatments.

Imaging Studies

Magnetic Resonance Imaging (MRI):
- Purpose: To rule out other conditions that might mimic Parkinson’s disease, such as strokes, brain tumors, or normal pressure hydrocephalus.
- Use: MRI is not used to diagnose Parkinson’s disease directly but helps exclude other causes of parkinsonism.
DaTscan (Dopamine Transporter Scan):
- Description: A specialized imaging test that involves injecting a radioactive tracer that binds to dopamine transporters in the brain, followed by a SPECT scan.
- Use: Helps visualize the dopamine system in the brain and can differentiate Parkinson’s disease from other disorders with similar symptoms, such as essential tremor or drug-induced parkinsonism.

Laboratory Tests

Blood Tests:
- Purpose: To rule out other conditions that might cause similar symptoms, such as thyroid dysfunction or metabolic disorders.
- Common Tests: Thyroid function tests, liver function tests, vitamin B12 levels, and others as indicated by the patient’s history and physical examination.

Differential Diagnosis

Atypical Parkinsonism:
- Conditions: Multiple system atrophy (MSA), progressive supranuclear palsy (PSP), corticobasal degeneration (CBD).
- Differences: These conditions may present with symptoms similar to Parkinson’s disease but often have additional features or different progression patterns.
Other Neurological Disorders:
- Conditions: Essential tremor, normal pressure hydrocephalus, Lewy body dementia, Wilson’s disease.
- Evaluation: Specific clinical features and additional tests help differentiate these conditions from Parkinson’s disease.

Conclusion

Diagnosing Parkinson’s disease is a complex process that relies on a comprehensive clinical evaluation, patient history, and physical examination. While there are no definitive tests for Parkinson’s disease, the combination of clinical criteria, response to medication, imaging studies, and exclusion of other conditions helps in making an accurate diagnosis. Early diagnosis and treatment are crucial for managing symptoms effectively and improving the quality of life for individuals with Parkinson’s disease. If Parkinson’s disease is suspected, it is important to consult a neurologist or a movement disorder specialist who can provide expert evaluation and care.

Jodi Knapp