In earlier articles, we have seen early signs of Parkinson's disease (PD) as well as some guidelines when one should seek a PD diagnosis. In this article, let us understand who is qualified to diagnose PD and what are the measures they use to do so.
Most current understanding of PD says that for a person to be diagnosed as PD affected, the person must have these (International Parkinson and Movement Disorder Society (MDS)) :
Bradykinesia (slowness of movement) AND one or more of the following
Shaking or tremors in a limb that occurs while at rest
Stiffness, rigidity of arms, legs or trunk
Trouble with balance and falls
Even though your loved one may be experiencing the above, it is best to get him/her diagnosed, so that proper treatment and other lifestyle measures can be employed and better understanding of the way forward is sought. In addition, appropriate lifestyle changes and medications can slow progression of PD. Also, be aware that some symptoms that look like PD could also be caused by other medical conditions.
Whom do you approach?
If symptoms are noticed over weeks, then the first doctor you could see is your family physician. They would ideally refer you to a neurologist. Depending on where you are based, you may have access to a neurologist who is further specialised in ‘movement disorders’.
How is it diagnosed?
Note that there is no specific lab test or imaging test that can conclusively diagnose PD. This means that the diagnosis is made were ‘clinically’ - ¹Conduct detailed assessment of the symptoms - there could be simplest of questions like :
Are you having trouble with buttoning or dressing
Do you see any changes in your handwriting
Do you have trouble brushing your teeth
Take the person’s medical and family history
Lifestyle factors that may impact the condition
Current and past medications
Do a physical examination which would centre around :
Agility of arms and legs
Any impact on expression and speech
Tremor in your extremities at rest or in action
Any stiffness in your extremities or neck
Person’s walking - step size, and ability to turn
Ability to maintain balance and examine your posture
Are there specific tests?
While there is no conclusive test so far, certain tests such as magnetic resonance imaging of the brain (MRI brain), a dopamine transporter scan (DaT scan), or blood work can be used. MRI looks at the structure of the brain, whereas DaT scan looks at the function of the brain (as the name suggests).
Note that, none of these tests may be ordered and that is fine if the neurologist is fully satisfied about his/her clinical diagnosis.
The process of PD diagnosis is lengthy, as it would require more than one visit to the physician, but on a positive note it does not involve too many tests.
A proper diagnosis is key to management of PD in ensuing months and years.
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