At what stage was your Parkinson's disease diagnosed?
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How is Parkinson's disease diagnosed?
An early and accurate diagnosis of Parkinson's disease is important in
developing good treatment strategies to maintain a high quality of life for as
long as possible. However, there is no test to diagnose Parkinson's disease with
certainty (except after the individual has passed away). A diagnosis of
Parkinson's disease - especially in the early phase - can be challenging due to
similarities to related movement disorders and other conditions with
Parkinson-like symptoms. Individuals may sometimes be misdiagnosed as having
another disorder, and sometimes individuals with Parkinson-like symptoms may be
inaccurately diagnosed as having Parkinson's disease. It is therefore important
to re-evaluate individuals in the early phase on a regular basis to rule out
other conditions that may be responsible for the symptoms.
A neurologist who specializes in movement disorders will be able to make the
most accurate diagnosis. An initial assessment is made based on medical history,
a neurological exam, and the symptoms present. For the medical history, it is
important to know whether other family members have Parkinson's disease, what
types of medication have been or are being taken, and whether there was exposure
to toxins or repeated head trauma in the past. A neurological exam may include
an evaluation of coordination, walking, and fine motor tasks involving the
Several guidelines have been published to assist in the diagnosis of
Parkinson's disease. These include the Hoehn and Yahr scale and the Unified
Parkinson's Disease Rating Scale. Tests are used to measure mental capacity,
behavior, mood, daily living activities, and motor function. They can be very
helpful in the initial diagnosis, to rule out other disorders, as well as in
monitoring the progression of the disease to make therapeutic adjustments. Brain
scans and other laboratory tests are also sometimes carried out, mostly to
detect other disorders resembling Parkinson's disease.
The diagnosis of Parkinson's disease is more likely if:
at least two of the three major symptoms are present (tremor at rest,
muscle rigidity, and slowness);
the onset of symptoms started on one side of the body;
symptoms are not due to secondary causes such as medication or strokes in the
area controlling movement; and
symptoms are significantly improved with levodopa (see below).