How Is Parkinsons Disease Tested And Diagnosed
At Banner Health, our neurologists have years of experience in testing and diagnosing Parkinson’s disease. Our team of compassionate experts knows that each patient is different, so we work with you to quickly find the right diagnosis to begin building your treatment plan.
Parkinsons is not simple to diagnose. No test exists to diagnose Parkinsons disease. Doctors test and diagnose Parkinsons based on your medical history, symptoms and neurological and physical exams.
Many times a primary care provider is the first to suspect a Parkinsons diagnosis. If youre experiencing symptoms such as tremors, shaking, slow movement, stiffness and/or trouble with balance, talk to your doctor or seek the opinion of a neurologist. Banner Health neurologists are movement disorder specialists, who have experience and specific training to assess and treat Parkinsons.
Can Parkinson’s Disease Be Cured
No, Parkinson’s disease is not curable. However, it is treatable, and many treatments are highly effective. It might also be possible to delay the progress and more severe symptoms of the disease.
A note from Cleveland Clinic
Parkinson’s disease is a very common condition, and it is more likely to happen to people as they get older. While Parkinson’s isn’t curable, there are many different ways to treat this condition. They include several different classes of medications, surgery to implant brain-stimulation devices and more. Thanks to advances in treatment and care, many can live for years or even decades with this condition and can adapt to or receive treatment for the effects and symptoms.
Will I Have To Pay For Treatment
If you are not eligible for a Medical Card you can get free medicines, medical and surgical appliances for the treatment of Parkinsons under the Long Term Illness Scheme. You will still have to pay for medicines prescribed to treat other conditions . In order to apply for the Long Term Illness Scheme you need to fill in the application form which is available from your Local Health Office. Your GP or Consultant will sign the form to confirm your condition and list your medicines or medical and surgical appliances. You will also need to specify the pharmacy where you want your medicines dispensed. If your doctor or occupational therapist prescribes a medical or surgical appliance, it will be supplied to you from your Local Health Office.
Even if you are not entitled to a medical card you may be eligible for GP Visit Cards which can allow individuals and families in Ireland to visit their family doctor for free. Only the cost of visits to your family doctor is free.
If you are not entitled to a medical card you should also apply for a Drugs Payment Scheme Card if you dont already have one, since other medicines not related to Parkinsons have to be paid for in the normal way but they will be covered by the Drugs Payment Scheme. This scheme ensures no individual or family has to pay more than a government determined maximum amount each month for medicines. The maximum amount is subject to government review from time to time.
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How Do You Know If Parkinson’s Is Progressing
During the final stage of the disease, some people may develop dementia or have hallucinations. However, hallucinations can also be a side effect of certain medications. If you or your loved ones notice that you’re getting unusually forgetful or easily confused, it might be a sign of advanced-stage Parkinson’s.
Deep Brain Stimulation Surgery
As Parkinsons disease progresses, deep brain stimulation surgery may become an option. Our team is one of the most experienced in the United States. Under the direction of Dr. Delaram Safarpour, Dr. Kim Burchiel, an OHSU neurosurgeon, pioneered asleep DBS so you dont have to be awake during surgery.
For this procedure, our team places tiny electrodes in your brain. The electrodes are connected to a small pacemaker-like device placed under the skin of your chest. The device sends mild electrical pulses to regulate movement and control Parkinsons symptoms such as:
In some parts of the state, you can have follow-up care at a doctors office in your community.
Colin Halstead had deep brain stimulation surgery at OHSU to treat his Parkinsons. It gave me my life back, he says.
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Obtaining A Parkinson’s Disease Diagnosis
During the exam, the neurologist will look for cardinal symptoms of the disease. Facial expressions and features will be assessed. The doctor will look for signs of tremor while the patient is at rest. The doctor may watch how easily the patient stands up from sitting in a chair. The doctor may also stand behind the patient and gently pull back on the patients shoulders and look for how easily the patient can regain balance. Good responsiveness to levodopa also helps support the diagnosis of PD. However, taking levodopa may exclude patients from clinical studies that need to recruit recently diagnosed patients who have not yet had treatment . Participation in a clinical trial should be discussed with the doctor.
PD can be challenging to accurately diagnose, particularly in early stages of the disease, which is why a neurologist trained in movement disorders is critical. Approximately 5-10% of patients with PD are misdiagnosed, as many of the symptoms of PD are similar to other diseases. If the patient thinks that he or she has been misdiagnosed, a second opinion may help.1,2
What Is Parkinson’s Disease
Parkinsons disease occurs when brain cells that make dopamine, a chemical that coordinates movement, stop working or die. Because PD can cause tremor, slowness, stiffness, and walking and balance problems, it is called a movement disorder. But constipation, depression, memory problems and other non-movement symptoms also can be part of Parkinsons. PD is a lifelong and progressive disease, which means that symptoms slowly worsen over time.
The experience of living with Parkinson’s over the course of a lifetime is unique to each person. As symptoms and progression vary from person to person, neither you nor your doctor can predict which symptoms you will get, when you will get them or how severe they will be. Even though broad paths of similarity are observed among individuals with PD as the disease progresses, there is no guarantee you will experience what you see in others.
Estimates suggest that Parkinsons affects nearly 1 million people in the United States and more than 6 million people worldwide.
For an in-depth guide to navigating Parkinsons disease and living well as the disease progresses, check out our Parkinsons 360 toolkit.
What Is Parkinson’s Disease?
Dr. Rachel Dolhun, a movement disorder specialist and vice president of medical communications at The Michael J. Fox Foundation, breaks down the basics of Parkinson’s.
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What Is Essential Tremor And How Is It Different To A Parkinsons Tremor
A tremor is a rhythmical, involuntary movement that affects a part of the body, such as the hand.
Essential tremor is the most common type of tremor. Its most noticeable when your hands are doing something and it usually affects both the right and left sides of the body equally. Essential tremors often lessen when your body is resting.
Unlike an essential tremor, a Parkinsons tremor is most obvious when the affected body part is resting and tends to be less noticeable with movement. It usually starts on one side of the body and may progress to the other side as Parkinsons develops.
The time it takes to get a diagnosis can vary from person to person. Some people may receive a diagnosis of Parkinsons quite quickly, but for others it may be a long process. This can be due to a number of things, including your medical history, your age and what symptoms you have.
Your specialist may wish to rule out other causes of your symptoms first and see how you respond to treatment. This may take some time, and, as already mentioned, there is currently no definitive test for Parkinsons.
How you respond to treatment may help your specialist make a diagnosis. Keeping a diary or record of your symptoms will give the specialist more information to guide their decision.
Because the symptoms of Parkinsons are sometimes similar to other forms of parkinsonism, people can sometimes be misdiagnosed.
How Is It Treated And Is There A Cure
For now, Parkinsons disease is not curable, but there are multiple ways to manage its symptoms. The treatments can also vary from person to person, depending on their specific symptoms and how well certain treatments work. Medications are the primary way to treat this condition.
A secondary treatment option is a surgery to implant a device that will deliver a mild electrical current to part of your brain . There are also some experimental options, such as stem cell-based treatments, but their availability often varies, and many aren’t an option for people with Parkinsons disease.
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Determining Diagnosis Through Response To Parkinsons Medication
If a persons symptoms and neurologic examination are only suggestive of Parkinsons disease, the physician may prescribe a medication intended for Parkinsons disease to provide additional information. In the case of idiopathic Parkinsons, there is typically a positive, predictable response to Parkinsons disease medication. In the case of some related Parkinsonian syndromes, the response to medication may not be particularly robust, or it may be absent entirely.
Unfortunately, there are no standard biological tests for the disease, such as a blood test. However, researchers are actively trying to find biomarkers in blood and other bodily fluids that could help confirm the diagnosis.
The Diagnostic Criteria Used Today
In 2015, a Movement Disorder Society task force proposed a set of criteria that became known as the Movement Disorder Society United Parkinsons Disease Rating Scale , which includes non-motor symptoms in its criteria.9
The new criteria requires you to have slowness of movement, plus either a rest tremor or rigidity. It also requires that you do not meet any criteria in a list called absolute exclusion criteria. This list of symptoms indicates you most likely do not have PD or that you may have an atypical parkinsonism disorders that resemble Parkinsons disease but are ultimately different. If you meet any of those requirements, PD is ruled out. For example, one absolute exclusion criteria is if you are taking a drug that is known to cause Parkinsons-like side effects.
Next, you must meet at least two of the following four criteria:
- Dramatic improvement of motor symptoms when you take the gold-standard Parkinsons medication called levodopa
- The presence of dyskinesia as a result of taking levodopa dyskinesia is a possible side effect of levodopa among people with PD
- Rest tremor, meaning your tremor occurs when the body part is at rest
- Loss of smell, or if you have a test called MIBG scintigraphy and it indicates that you have autonomic dysfunction, which is when your autonomic nervous system doesnt work correctly, leading to issues with things like heart rate and blood pressure.
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Assessing Level Of Rigidity
Healthcare providers also look for rigidity by moving the joints in your elbows, wrists, knees, and ankles to see if there’s resistance. The resistance may be smooth or may appear as slight hesitations in movements, known as cogwheeling. This is sometimes made more obvious by the patient actively moving the opposite limb.
Looking For Signs Of Parkinsons
Your specialist will examine you to look for common signs of Parkinsons. You may be asked to:
- write or draw to see if your writing is small or gradually fades
- walk to see whether theres a reduction in the natural swing of your arm or in your stride length and speed
- speak to see if your voice is soft or lacks volume
The specialist will also look at and ask you about your:
- face to see if there is a masked look or if you have difficulty with facial expressions
- limbs to see if you have a tremor, any stiffness or slowness of movement
As well as examining you for any of the typical signs of Parkinsons, the specialist will also look for signs that may suggest a different diagnosis.
It may be helpful to take someone with you for support when seeing a specialist. Taking a list of questions you want to ask can also be useful so you dont forget to mention something you want to know about. If a healthcare professional says something you dont understand, dont be afraid to ask them to explain what they mean.
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Locating The Basal Ganglia
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The basal ganglia are collections of nerve cells located deep within the brain. They include the following:
The basal ganglia help initiate and smooth out muscle movements, suppress involuntary movements, and coordinate changes in posture. |
Understanding Parkinsons Disease: Getting A Parkinsons Diagnosis
Once you start noticing some changes in your body that impact your daily life or are just simply bothersome, you should begin the process of figuring out if you have Parkinsons disease. It may seem like a daunting undertaking, but dont let fear stop you. Once you are diagnosed, you can start treating your symptoms and learning strategies that will help you feel better.
Recommended Reading: Cleveland Clinic Parkinsons Center Of Excellence
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Other Challenges Of Diagnosing Parkinsons Disease
Parkinsons disease progresses slowly, often with non-motor symptoms appearing months or years before motor symptoms. This can make it challenging for doctors to diagnose you in the early stages, especially since the diagnostic criteria is based mostly on motor symptoms. You may have to wait until your symptoms progress for you and your doctor to confirm your diagnosis.14
Age and gender can be another issue. Since Parkinsons is associated more with older men, doctors may not think their younger or female patients have Parkinsons.5 On the other hand, since the disease is associated with aging, your symptoms may be blamed on getting older.
Remember that movement disorder specialists are extremely knowledgeable about Parkinsons disease and can help put the pieces together where other more generalized doctors may not. Never hesitate to fight for the care you deserve.
Related: Heres whats important to remember if you were just diagnosed with Parkinsons disease.
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Can Parkinsons Disease Be Cured
No, Parkinsons disease is not curable. However, it is treatable, and many treatments are highly effective. It might also be possible to delay the progress and more severe symptoms of the disease.
A note from Cleveland Clinic
Parkinsons disease is a very common condition, and it is more likely to happen to people as they get older. While Parkinsons isnt curable, there are many different ways to treat this condition. They include several different classes of medications, surgery to implant brain-stimulation devices and more. Thanks to advances in treatment and care, many can live for years or even decades with this condition and can adapt to or receive treatment for the effects and symptoms.
Read Also: How Can I Tell If I Have Parkinson Disease
What Medications And Treatments Are Used
Medication treatments for Parkinsons disease fall into two categories: Direct treatments and symptom treatments. Direct treatments target Parkinsons itself. Symptom treatments only treat certain effects of the disease.
Medications
Medications that treat Parkinsons disease do so in multiple ways. Because of that, drugs that do one or more of the following are most likely:
Several medications treat specific symptoms of Parkinson’s disease. Symptoms treated often include the following:
- Erectile and sexual dysfunction.
- Hallucinations and other psychosis symptoms.
Deep brain stimulation
In years past, surgery was an option to intentionally damage and scar a part of your brain that was malfunctioning because of Parkinsons disease. Today, that same effect is possible using deep-brain stimulation, which uses an implanted device to deliver a mild electrical current to those same areas.
The major advantage is that deep-brain stimulation is reversible, while intentional scarring damage is not. This treatment approach is almost always an option in later stages of Parkinson’s disease when levodopa therapy becomes less effective, and in people who have tremor that doesnt seem to respond to the usual medications.
Experimental treatments
Researchers are exploring other possible treatments that could help with Parkinsons disease. While these arent widely available, they do offer hope to people with this condition. Some of the experimental treatment approaches include:
How Is It Diagnosed
Diagnosing Parkinson’s disease is mostly a clinical process, meaning it relies heavily on a healthcare provider examining your symptoms, asking you questions and reviewing your medical history. Some diagnostic and lab tests are possible, but these are usually needed to rule out other conditions or certain causes. However, most lab tests aren’t necessary unless you don’t respond to treatment for Parkinson’s disease, which can indicate you have another condition.
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What Is Parkinsons Disease
Parkinsons disease is a condition where a part of your brain deteriorates, causing more severe symptoms over time. While this condition is best known for how it affects muscle control, balance and movement, it can also cause a wide range of other effects on your senses, thinking ability, mental health and more.
How Will The Disease Affect My Life
Most people who have Parkinsonâs live a normal to a nearly normal lifespan, but the disease can be life changing.
For some people, treatment keeps the symptoms at bay, and they’re mostly mild. For others, the disease is much more serious and really limits what you’re able to do.
As it gets worse, it makes it harder and harder to do daily activities like getting out of bed, driving, or going to work. Even writing can seem like a tough task. And in later stages, it can cause dementia.
Even though Parkinson’s can have a big impact on your life, with the right treatment and help from your health care team, you can still enjoy the things you love. It’s important to reach out to family and friends for support. Learning to live with Parkinson’s means making sure you get the backing you need.
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