About Parkinson's Disease

How is Parkinson's Diagnosed?

Because Parkinson's has symptoms similar to a number of other neurological disorders and because every case is unique, diagnosis of the disease can be difficult.  There are similar conditions, often referred to as Parkinson’s Plus syndromes or atypical-Parkinson syndromes, which make diagnosis and treatment problematic.  As such, a thorough examination is required by a specialist doctor or Neurologist.  Sometimes it may take several examinations over a period of time (perhaps several years) before the diagnosis can be made confidently.  

The doctor will discuss your general medical history looking for the main Parkinson’s symptoms.  Certainly he or she will be looking for slowness of movement (bradykinesia) accompanied by at least one of the following: Tremor, Rigidity and/or difficulty with balance. 

Diagnosis may be further confirmed if there is a positive response to medication used to treat Parkinson’s, whereas other similar conditions may not respond well to such treatments.

Blood tests may be carried out to eliminate other causes of symptoms.  ‘Neuro-imaging’ may also be performed which shows and assesses the anatomy and functioning of the brain and other parts of the Nervous system, and can effectively rule out conditions that have similar symptoms.  

Neuro-imaging that may be performed (but not in all cases) are: 

  • CT (computerised tomography) scan: x-rays are passed through the body from different angles to build up a cross-sectional anatomical picture of the brain.  This scan may be used to exclude vascular disease and tumours as the cause of Parkinson-type symptoms 
  • MRI (magnetic resonance imaging) scan: uses magnetic charges rather than x-ray to form images of the brain or other parts of the body.  This can be helpful in differentiating between Parkinson’s and Parkinson’s-like conditions such as PSP and MSA by revealing structural differences.  Accuracy is thought to be around 60-80% 
  • DaTSCAN™-SPECT: this involves injecting the patient with a product containing a small amount of radioactivity which then binds itself to Dopamine-releasing Neurons. The signal is measured with a SPECT (single photon emission computed tomography) camera: a high signal indicating that there are many surviving dopamine neurons, and a low signal indicating a depleted level of these neurons.   A low signal suggests Parkinson’s syndromes, but does not differentiate between different types of the disease. DaTSCAN can, however, be used for differentiating Parkinson’s from Essential Tremor. It can also be used for specifically identifying Lewy body dementia as opposed to other types of Dementia 
  • IBZM-SPECT: other types of tracers, such as IBZM (iodobenzamide) and SPECT, can also be used to help in differentiating different types of Parkinson’s syndromes 
  • PET (positron emission tomography) scan: another type of scanning technique, PET can be used for helping with Parkinson’s diagnostics.  But as it is more expensive and not as readily available as SPECT, PET is predominantly used as a research instrument. 

New imaging techniques are being developed and research is also under way into new blood tests which can detect Parkinson’s, but it may be some years before these become available.

'Parkinsonism' is an umbrella term used to describe various conditions that all have tremor, rigidity and slowness of movement as their main symptoms. The most common form of 'Parkinsonism' is Parkinson's, but other conditions such as Multiple System Atrophy (MSA), Vascular Parkinsonism and Progressive Supranuclear Palsy (PSP) also exist.

Source: EPDA www.epda.eu.com

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