What Other Tests Are Used To Confirm A Parkinsons Diagnosis
Because there isnt a specific test for Parkinsons disease, doctors instead assess patients and look for key symptoms of Parkinsons, such as tremors, slow movements, or stiffness. The presence of these symptoms, along with a review of a persons medical history, can often be used to diagnose Parkinsons.
In some cases, a doctor might order tests to rule out other conditions that can cause similar symptoms. This can include MRIs and other imaging tests, such as PET scans. It might also include bloodwork, urine samples, and other lab work. This type of testing cant help diagnose Parkinsons, but it can help confirm a suspected Parkinsons diagnosis.
Parkinsons can take several months and several visits to diagnose. Often, doctors will prescribe Parkinsons medications before theyre certain of a diagnosis. A persons response to Parkinsons medications can be a strong indicator of whether their symptoms are caused by Parkisons or by another condition.
Primary Symptoms Of Parkinsons
The symptoms someone has and how quickly the condition develops will differ from one person to the next. Always consult your doctor to determine if the symptoms youre experiencing may be a sign of Parkinsons disease or a sign of other health issues.
Slowness of Movement
Individuals with Parkinsons disease experience a change in spontaneous movement that causes them to move or respond slowly. The face may lack changing facial expressions .
Tremor
Tremors occur in about 70% of those living with Parkinsons. Typically, the tremor appears on one side of the body in the hand or foot while relaxed or at rest.
Rigidity
Muscles may fail to relax like normal muscles causing the individual to appear rigid and have a decreased range of motion. Rigidity can cause posture changes. Tightness of the muscles of the body may be painful.
Postural Instability
Loss of some reflexes needed to maintain an upright posture may cause individuals to be unstable when standing. The presence of postural instability increases the likelihood of falling.
Secondary motor symptoms include:
Non-motor symptoms of PD include:
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.
Don’t Miss: Wrist Weights For Parkinson’s Tremors
What Are The Treatments
Currently there is no cure for Parkinsons disease.
Symptoms can be mild in the early stages of the condition and people might not need immediate treatment. Your doctor and specialist will monitor your situation.
There are several different types of drugs used to treat Parkinsons disease. Drug treatments are tailored to each individuals needs and are likely to involve a combination of different drugs. Your medication should be reviewed regularly. It is likely that, over time, changes will be made to the types of drugs you take and the doses you take each day.
The main types of drug treatment for Parkinsons disease are:
- drugs which replace dopamine
- drugs which mimic the role of dopamine
- drugs which inhibit the activity of acetylcholine
- drugs which prevent the body breaking down dopamine
- other drugs such as anti-sickness medication
Everybody is affected differently by medication. The possible side effects of Parkinsons disease drugs include nausea , vomiting , tiredness and dizziness. Some people might experience confusion, nightmares and hallucinations. For some people, dopamine agonists have been linked to compulsive behaviour such as addictive gambling or hypersexuality .
The effectiveness of the main drug treatment levodopa can wear off over time and its long-term use can cause some people to develop involuntary twisting or writhing movements of the arms, legs or face . To reduce the risk, doctors might delay the use of levodopa for younger people.
Mri In Parkinson’s Testing
One of the more common tests done during a neurologic workup is an MRI scan and one may think that in the investigation of a disease that affects the brain such as Parkinsons, this imaging test would be a necessity. In the context of Parkinsons disease, however, an MRI is not particularly helpful. It looks at the structure of the brain which, for all intents and purposes, appears normal in this disease. An MRI may, however, be indicated when symptoms appear in younger people or if the clinical picture or the progression of symptoms is not typical for Parkinsons. In these situations, MRI can be used to rule out other disorders such as stroke, tumors, hydrocephalus , and Wilsons Disease .
Don’t Miss: Cell Replacement Therapy For Parkinson’s 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:
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.
You May Like: Parkinson’s Disease Foundation Donation
What Medications Are Used To Treat Parkinsons Disease
Medications are the main treatment method for patients with Parkinsons disease. Your doctor will work closely with you to develop a treatment plan best suited for you based on the severity of your disease at the time of diagnosis, side effects of the drug class and success or failure of symptom control of the medications you try.
Medications combat Parkinsons disease by:
- Helping nerve cells in the brain make dopamine.
- Mimicking the effects of dopamine in the brain.
- Blocking an enzyme that breaks down dopamine in the brain.
- Reducing some specific symptoms of Parkinsons disease.
Levodopa: Levodopa is a main treatment for the slowness of movement, tremor, and stiffness symptoms of Parkinsons disease. Nerve cells use levodopa to make dopamine, which replenishes the low amount found in the brain of persons with Parkinsons disease. Levodopa is usually taken with carbidopa to allow more levodopa to reach the brain and to prevent or reduce the nausea and vomiting, low blood pressure and other side effects of levodopa. Sinemet® is available in an immediate release formula and a long-acting, controlled release formula. Rytary® is a newer version of levodopa/carbidopa that is a longer-acting capsule. The newest addition is Inbrija®, which is inhaled levodopa. It is used by people already taking regular carbidopa/levodopa for when they have off episodes .
What Are The First Symptoms Of Early Onset Parkinsons And When Should I See A Doctor
There are some early warning signs associated with Parkinsons. These symptoms dont always mean a person will develop Parkinsons but can be a signal that its very likely. Symptoms that can act as early warning signs include:
- speaking very quickly
- difficulty writing and changes to handwriting
Its a good idea to talk with a doctor about any early warning signs symptoms or early symptoms of Parkinsons you experience.
Also Check: Ending Parkinson’s Disease A Prescription For Action
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.
When Should I See My Healthcare Provider Or When Should I Seek Care
You should see your healthcare provider as recommended, or if you notice changes in your symptoms or the effectiveness of your medication. Adjustments to medications and dosages can make a huge difference in how Parkinsons affects your life.
When should I go to ER?
Your healthcare provider can give you guidance and information on signs or symptoms that mean you should go to the hospital or seek medical care. In general, you should seek care if you fall, especially when you lose consciousness or might have an injury to your head, neck, chest, back or abdomen.
You May Like: Can Parkinsons Be Treated If Caught Early
Parkinsons Disease Can Be Prevented
There does not seem to be a way to predict or prevent Parkinsons disease. Current research is investigating a biomarker â some kind of biological abnormality that would be present in patients with PD â that would be able to be detected from testing. This could help doctors identify people who are at-risk for developing Parkinsons and thus find treatments to stop the disease process in the early stages or slow the progression. There are rare cases of genetically inherited PD where researchers can test for these genetic biomarkers to determine a persons risk for developing the disease.
Recommended Reading: Nursing Management Of Parkinsons Disease
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.
Read Also: What Drugs Cause Parkinson Like Symptoms
Pd Diagnosis Disease Severity And Disease Progression
The diagnosis of PD is essentially clinical , and we believe that the clinical evaluation of patients will not be replaced by modern imaging techniques. Nevertheless, as pointed out earlier, misdiagnosis can approach 20% of cases . Recently, in line with the European Union, the U.S. FDA approved DAT scan as a diagnostic tool to help differentiate between PD and Essential Tremor. This is the only current FDA-approved subsidiary examination to aid in PD diagnosis.
The role of magnetic resonance imaging in the diagnosis of PD is still not fully established. Traditionally, it has been seen as a means to potentially exclude alternate diagnoses such as vascular parkinsonism, or more importantly , atypical forms of degenerative parkinsonism such as MSA or progressive supranuclear palsy . Traditional structural MRI findings of these latter diagnoses such as increased pallidal iron, rim of putaminal hyperintensity, hot cross bun sign and/or cerebellar atrophy in MSA or the hummingbird or penguin sign in PSP may not be reliable, particularly in early disease.
Figure 5. Multimodal MRI in PD. Differences are noted between patients with PD and controls through voxel-based analysis of R2, mean diffusivity, and fractional anisotropy maps.
-
Low dopamine transporter uptake in basal ganglia demonstrated by SPECT or PET imaging.*
Brent A. Vogt, in, 2019
If Its Not Parkinsons Disease What Else Could It Be
There are several other conditions that might produce symptoms that can be mistaken for Parkinsons disease. Here are some possibilities:
- Medication side effects: Certain drugs can produce or exacerbate symptoms.
- Essential, or familial, tremor: This is a relatively common and benign cause of recurrent tremor and is often confused with the tremor of idiopathic Parkinsons. A general neurologist or movement disorder specialist is the best physician to help differentiate between these two conditions.
- A Parkinsonian syndrome: The symptoms of several neurologic conditions are similar to those of idiopathic Parkinsons, but they are often managed differently and often do not respond to the typical medications.
Remember: Only a general neurologist or movement disorder specialist can tell you with reasonable certainty if you have idiopathic Parkinsons. If for some reason you are not comfortable with the results of your first physician visit, getting a second opinion from another general neurologist or movement disorder specialist is always an option. It is important that you feel comfortable with your physician to ensure the best possible outcome for you.
Once you or your loved one has a diagnosis of Parkinsons disease, it is time to discuss treatment options with your physician.
Recommended Reading: New Hope For Parkinson’s
How Is It Treated
At this time, there is no cure for Parkinsons disease. But there are several types of medicines that can control the symptoms and make the disease easier to live with.
You may not even need treatment if your symptoms are mild. Your doctor may wait to prescribe medicines until your symptoms start to get in the way of your daily life. Your doctor will adjust your medicines as your symptoms get worse. You may need to take several medicines to get the best results.
Levodopa is the best drug for controlling symptoms of Parkinsons. But it can cause problems if you use it for a long time or at a high dose. So doctors sometimes use other medicines to treat people in the early stages of the disease.
The decision to start taking medicine, and which medicine to take, will be different for each person. Your doctor will be able to help you make these choices.
In some cases, a treatment called deep brain stimulation may also be used. For this treatment, a surgeon places wires in your brain. The wires carry tiny electrical signals to the parts of the brain that control movement. These little signals can help those parts of the brain work better.
There are many things you can do at home that can help you stay as independent and healthy as possible. Eat healthy foods. Get the rest you need. Make wise use of your energy. Get some exercise every day. Physical therapy and occupational therapy can also help.
Questions To Ask Your Doctor
Its a good idea to ask questions as you and your doctor discuss a treatment. Asking questions can help you make sure you understand your condition and the benefits of treatment. Here are some sample questions to ask your doctor:
- Is it possible something other than Parkinsons is causing my symptoms?
- Do I need additional tests?
- How will my condition progress?
- What can I expect as my condition progresses?
- How will Parkinsons affect my other medical conditions?
- What treatments are available?
- Which treatments are best for me?
- How will treatments help my current symptoms?
- Will treatment slow down the progression of Parkinsons?
- What side effects do your recommended treatments have?
- What happens if these treatments dont help?
- Can you recommend any resources or educational material for me?
Read Also: Parkinson’s And Immune System