Parkinson’s disease is a condition that occurs over a long period of time, often starting with symptoms that are virtually unnoticeable. One of the most difficult aspects of Parkinson’s disease is that there isn’t one test that can rule it out. It comes down to experience, judgment, and observation, and lastly, ruling out other potential conditions.

Patients are commonly seen at Royal Care Neurosciences who are unsure of their symptoms. There are plenty of people who suffer from minor changes for long periods of time without an answer. Putting yourself at risk is never a favorable circumstance. Diagnosing Parkinson’s disease is a critical step for potential future patients and the community.

Parkinson’s Disease Explained

Parkinson’s disease is a condition that is categorized as a progressive neurological condition. It directly affects the way people are able to move. This occurs because the cluster of nerve cells that creates dopamine is no longer able to produce this lucrative chemical. The body uses dopamine as a basis for the body to create smoothly, and with great control, coordinated movements.

As we get older, it is common for people to experience changes in the way they move and their level of coordination. A decrease in the levels of dopamine that exist in the body can create an increased propensity for people to experience diminished capabilities with regard to their movements and their coordination.

Symptoms to Look Out For

Before diagnosing a person with Parkinson’s disease, a doctor will look for a specific series of symptoms. These are broad, but can be broken down into various categories, including motor and non-motor symptoms.

Motor Symptoms

• Tremors, especially when resting
• Slowness of movement (bradykinesia)
• Muscle stiffness or rigidity
• Problems with balance and falling often
• Reduced arm swing when walking

Non-Motor Symptoms

• Loss of smell
• Constipation
• Sleep problems, including dream enactment
• Changed moods, such as anxiety or depression
• Speech that is quiet or low

All of these symptoms may not appear altogether. They usually happen on one side of the body and slowly spread.

Diagnosing Parkinson’s Disease

Most other conditions have tests available, like blood tests or imaging, that can confirm a diagnosis. Parkinson’s doesn’t have that. Symptoms of Parkinson’s Disease are often the same as those of other nervous system disorders, especially when symptoms start.

Here are some of the main challenges:

• Symptoms happen gradually. This can be confused with the normal ageing process.
• There is a lot of overlap with other conditions. Disorders like essential tremor, or other types of Parkinsonism can be very similar.
• Each person can experience a different set of symptoms, and the speed of progression can be different.

All of these challenges mean that diagnosis comes down to the clinician’s judgement and experience.

Diagnosing Parkinson’s disease is usually a series of steps, not just one simple test.

1. Medical History

The doctor will ask if there are any symptoms, if so, when these symptoms started, and how they have changed. They could also ask about family history, lifestyle, exposure to toxins, or head trauma.

 2. Neurological Exam

The neurologist will check movement, muscle tone, coordination, and reflexes. They could ask to do some everyday tasks, like walk, write, or tap fingers.

Some of the major things they look for are: resting tremor, slowness of movement and muscle rigidity.

3. Time Observation

If the symptoms are not clear, they could take some time to see how the symptoms develop.

4. Medication Response

One of the best things to help diagnose Parkinson’s is how the body responds to the medication, levodopa, and if the symptoms improve, it further supports the diagnosis of parkinsons.

Diagnosing Parkinson’s
There is no singular test for Parkinson’s, but there are tests that help eliminate the possibility of other disorders.

MRI

MRI scans are used to eliminate other possible causes of symptoms, such as brain tumours, strokes, or other structural causes.

DaTscan (Dopamine Transporter Scan)

This imaging test evaluates brain activity and its use may support diagnosis in unclear situations, though it is not always necessary.

Blood Tests

While tests are not used in the diagnosis of Parkinson’s, they may eliminate other conditions that produce similar symptoms.

Conditions That May Mimic Parkinson’s

Parkinson’s has to be differentiated from other conditions that look similar.

• Essential Tremor: causes shaking while moving, but not while at rest.
• Atypical Parkinsonism: Includes multiple system atrophy or progressive supranuclear palsy, which may progress even faster.
• Drug-Induced Parkinsonism: is due to certain drugs and may improve once the offending drug is stopped.

Treatment and prognosis may shift substantially in these scenarios, which is why this is critical.

The Right to Know

While Parkinson’s is not curable, with the right treatment (drugs, physiotherapy and lifestyle changes), the disruption of daily activities may be minimal, and many patients may even manage to carry on with their daily activities.

For patients and families, with an early diagnosis and the right treatment plan, this allows for future planning and understanding of the condition. Patients may carry on with daily activities with minimal disruption.

When Should You See a Doctor?

In case you have ongoing muscle jerking, stiffness, slow movement, or trouble with walking and balance, it is a good idea to contact a neurologist. Don’t neglect other symptoms that could be related, such as trouble with sleep or even trouble smelling, as those could still be neurological issues as well.

Just because you seek medical advice early does not mean you will have a diagnosis of Parkinson’s; it does mean that medical attention and evaluation will take place.

Conclusion

Diagnosis of Parkinson’s disease is not easy. There are many components that are examined, and without a specific diagnostic test, multiple pieces of a puzzle need to be integrated and observed before the correct diagnosis is made.

Understanding the steps involved in the diagnostic process allows for a reduction in the burden or amount of anxiety associated with the concern. We are dedicated to accurate diagnosis as well as patient-centred care and support at Royal Care Neurosciences.

Frequently Asked Questions

1. Is there one conclusive test to determine the presence of Parkinson’s Disease?

Unfortunately, there is unfortunately no one conclusive test that exists that will determine the presence of Parkinson’s Disease. Diagnoses are determined based on clinical symptoms, neurological examinations, and the patient’s response to a course of medication.

2. Is the process of diagnosing Parkinson’s Disease the same for everyone?

It varies for each individual because the daisy path to diagnosis differs person to person. An individual may experience a quick diagnosis, while others may require multiple visits over extended periods to eventually reach a diagnosis.

3. Can Parkinson’s disease be misdiagnosed?

Yes, it can, particularly in the early stages, since symptoms can be similar to other illnesses. This is why it’s critical to be evaluated by a neurologist.