Parkinson's disease is a challenging condition to diagnose. There are no definitive laboratory tests that can confirm a diagnosis. In some cases the patient and/or family members are the first to notice symptoms and realize that something is wrong. Since there are no specific tests for Parkinson's disease, making an accurate diagnosis means being aware of the common warning signs and symptoms and getting a complete physical examination.
Physical Examination
The first step in correctly diagnosing Parkinson's disease is to review the history of symptoms that are present. This can be challenging because in some cases, symptoms are very mild or general in the early stages.
However, to be diagnosed with PD, two out of the four most common symptoms need to be present, claims the National Parkinson's Foundation. This includes a tremor that commonly affects the hands first and is worse at rest, movement that is slower than normal for the patient, stiffness or lack of range of motion in the arms, legs or trunk and an inability to maintain balance or a history of falls. If these symptoms are present, especially on just one side of the body, a physician may prescribe Parkinson's medications. If the medications improve the symptoms, then the patient probably has PD.
In addition, family members may notice speech becoming softer, small cramped handwriting and quick shuffling steps with a tendency to walk on the toes.
Neurological Examination
If Parkinson's disease is suspected, a neurologist may perform an exam to test how the patient moves. This may include asking the patient to get in and out of a chair, walk across the room, make facial expressions, draw, write and reach for objects. Individuals with PD tend to hold the arms stiff while walking, have a hard time transitioning between various positions and tend to lack facial expression.
The results of this exam may be compared against the United Parkinson's Disease Rating Scale, which is often used to confirm a diagnosis. It is a scale where symptoms are rated from zero to four based on severity, with four being severe. It is based partly on a patient's report of how daily life is affected by the symptoms, combined with the results obtained during the office visit.
If PD is suspected, the Parkinson's Disease Foundation recommends seeking out a neurologist who has specialized training in diagnosing Parkinson's disease, in order to catch it as early as possible.
Brain Scans
According to the Mayo Clinic, in some cases a diagnosis of Parkinson's disease can be made only after ruling out other causes for the symptoms. This is because head injuries and other medical conditions can cause similar symptoms. Performing a brain scan may help to detect damage to the brain from another condition, which would rule out a diagnosis of Parkinson's disease.
In addition, being exposed to toxins or taking certain medications can also cause symptoms that mimic this disease. Typical medications that cause these side effects include Thorazine, Compazine and Reglan. During an exam it is important to discuss all medcations, including herbal and over the counter that are being taken.
