Diagnoses

The examination by a neurologist remains the first and most important diagnostic tool for Parkinson’s disease (PD). At this time there is no perfect test to determine PD, although much research is being done.

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A neurologist or will make the diagnosis based on:

• A detailed history of symptoms, medical problems, current and past medications. Certain medical conditions, as well as some medications, can cause symptoms similar to Parkinson’s.

• A detailed neurological examination during which a neurologist will ask you to perform tasks to assess the agility of arms and legs, muscle tone, gait and balance, to see if: expression and speech are animated, tremor can be observed in your extremities at rest or in action, there is stiffness in extremities or neck, or if you can maintain your balance and examine your posture.

• Most commonly, people with PD respond well to dopaminergic medications. Lack of response to medications may prompt the doctor to seek an alternative diagnosis such as atypical parkinsonism and order further testing such as an MRI (magnetic resonance imaging) of the brain.

 

When unsure of a PD diagnosis, neurologists often refer patients to movement disorders specialists.

 

Finding the right doctor is an important part of your treatment.  If at all possible, make an appointment with a movement disorders specialist. A movement disorders specialist is a neurologist who has taken additional training in the subspecialty in neurology called movement disorders (as compared to other subspecialties in neurology). Movement disorders specialists are most often also involved in research and/or teaching in addition to their clinical concerns and are more typically found at major medical institutions. Such professionals typically follow a greater number of patients with these disorders and are generally more experienced in the use of the various medications compared to a general neurologist, an internist or general practitioner. 

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