If Its Not Parkinsons Disease What Could It Be
Here are some possibilities:
Side effects of medication: Certain drugs used for mental illnesses like psychosis or major depression can bring on symptoms like the ones caused by Parkinsonâs disease. Anti-nausea drugs can, too, but they typically happen on both sides of your body at the same time. They usually go away a few weeks after you stop taking the medication.
Essential tremor: This is a common movement disorder that causes shaking, most often in your hands or arms. Itâs more noticeable when youâre using them, like when you eat or write. Tremors caused by Parkinsonâs disease usually happen when youâre not moving.
Progressive supranuclear palsy: People with this rare disease can have problems with balance, which may cause them to fall a lot. They donât tend to have tremors, but they do have blurry vision and issues with eye movement. These symptoms usually get worse faster than with Parkinson’s disease.
Normal pressure hydrocephalus : This happens when a certain kind of fluid builds up in your brain and causes pressure. People with NPH usually have trouble walking, a loss of bladder control, and dementia.
Preparing For A Parkinsons Mri
A Parkinsons MRI is completely painless, but you do have to lie still while being scanned. Some patients feel claustrophobic in this situation. If youre worried about that, talk with your doctor about the possibility of having an anti-anxiety medication before the procedure.
On the day of the appointment, follow any instructions provided to you by your doctor. Remove metal jewelry and dont wear make-up as that can also have metal in it. If you are in the advanced stages of Parkinsons or if you are taking a sedative, you should arrange transportation to and from the appointment.
Testing For Parkinsons Disease
There is no lab or imaging test that is recommended or definitive for Parkinsons disease. However, in 2011, the U.S. Food and Drug Administration approved an imaging scan called the DaTscan. This technique allows doctors to see detailed pictures of the brains dopamine system.
A DaTscan involves an injection of a small amount of a radioactive drug and a machine called a single-photon emission computed tomography scanner, similar to an MRI.
The drug binds to dopamine transmitters in the brain, showing where in the brain dopaminergic neurons are.
The results of a DaTscan cant show that you have Parkinsons, but they can help your doctor confirm a diagnosis or rule out a Parkinsons mimic.
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Referral To A Specialist
If your GP suspects Parkinson’s disease, you’ll be referred to a specialist.
This will usually be:
- a neurologist, a specialist in conditions affecting the brain and nervous system
- a geriatrician, a specialist in problems affecting elderly people
The specialist will most likely ask you to perform a number of physical exercises so they can assess whether you have any problems with movement.
A diagnosis of Parkinson’s disease is likely if you have at least 2 of the 3 following symptoms:
- shaking or tremor in a part of your body that usually only occurs at rest
- slowness of movement
- muscle stiffness
If your symptoms improve after taking a medication called levodopa, it’s more likely you have Parkinson’s disease.
Special brain scans, such as a single photon emission computed tomography scan, may also be carried out in some cases to try to rule out other causes of your symptoms.
Looking For Signs Of Parkinsons
Your specialist will examine you to look for common signs of Parkinsons. You may be asked to:
- write or draw to see if your writing is small or gradually fades
- walk to see whether theres a reduction in the natural swing of your arm or in your stride length and speed
- speak to see if your voice is soft or lacks volume
The specialist will also look at and ask you about your:
- face to see if there is a masked look or if you have difficulty with facial expressions
- limbs to see if you have a tremor, any stiffness or slowness of movement
As well as examining you for any of the typical signs of Parkinsons, the specialist will also look for signs that may suggest a different diagnosis.
It may be helpful to take someone with you for support when seeing a specialist. Taking a list of questions you want to ask can also be useful so you dont forget to mention something you want to know about. If a healthcare professional says something you dont understand, dont be afraid to ask them to explain what they mean.
Read Also: Can Parkinson’s Run In The Family
Datscan For Parkinsons Disease
When other neurological exams cannot confirm or rule out Parkinsons disease, Radiology and Imaging Specialists can offer a DaTscan that can help secure the right diagnosis. This form of nuclear medicine testing is highly useful for distinguishing between Parkinsons Disease and essential tremor .
Contact Radiology and Imaging Specialists
How Can Magnetic Resonance Imaging Help
Magnetic resonance imaging is used to monitor a large variety of disorders and diseases throughout the body. the images produced during an MRI scan may show tissue structures and organs in excellent detail. Functional MRI is one technique that can provide information about the body during certain activities. Both conventional and functional MRI may help show the progress of diseases, including Parkinson’s disease, and may show the response to treatments.
Functional MRI may be used to image the brain during movement. Research for Parkinson’s disease has included fMRI to monitor what regions are activated during automatic motion.4 This study of 12 patients with Parkinson’s disease practiced sequences of finger movement until they were able to be done automatically. Then, they underwent fMRI to compare their scans before and after they had learned the sequences. The results showed that the most of the same areas of the brain were active while performing the sequences before or after they became automatic. Subjects without Parkinson’s had significantly reduced activity in the brain after automaticity. This means that patients with Parkinson’s disease had more trouble performing the actions than the people without.
Diagnosing And Treating Parkinsons Disease
The diagnosis of Parkinsons disease is largely based upon the type of symptoms that the patient experiences. When someone has symptoms such as tremors or shaking of arms or legs while at rest, muscle stiffness or slow movements, Parkinsons disease must be a consideration, particularly if the individual is at a typical age for the onset of the disorder. Not all patients have every symptom, and often the symptoms start on one side of the body and then progress over time to include the other side. A good response to a trial of Parkinsons disease medication also helps to add confidence to the diagnosis.
The symptoms of Parkinsons disease can be similar to the symptoms of other conditions, and it is frequently misdiagnosed. Skilled doctors who specialize in the treatment of Parkinsons disease are the best practitioners to see for an accurate diagnosis.
The diagnostic process begins with a full medical history and neurological exam, testing movement, strength, coordination, balance, and reflexes. A doctor will often order additional tests to make sure that there are no other conditions present that could explain the patients symptoms. These tests may include an MRI of the brain and/or spine, or diagnostic tests of the electrical responses of muscles and nerves. In Parkinsons disease, these are usually normal and are performed to make sure that there are not problems other than Parkinsons disease that could explain symptoms.
Tests To Rule Out Other Conditions
Blood tests can help rule out other possible causes of the symptoms, such as abnormal thyroid hormone levels or liver damage.
Hydrocephalus due to atrophy can occur with some types of dementia and would be visible with one of these imaging tests. If the person has neurologic symptoms but a normal scan result, Parkinsons disease may be present.
The doctor a lumbar puncture to rule out inflammation or a brain infection.
Also Check: Can Parkinson’s Run In The Family
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.
What Tests Might I Have
People who have Parkinsonâs disease donât make enough of a brain chemical called dopamine, which helps you move. If those first tests donât show a reason for your symptoms, your doctor may ask you to try a medication called carbidopa-levodopa, which your brain can turn into dopamine. If your symptoms get much better after you start the drug, your doctor probably will tell you that you have Parkinsonâs disease.
If the medication doesnât work for you and thereâs no other explanation for your issues, your doctor might suggest an imaging test called a DaTscan. This uses a small amount of a radioactive drug and a special scanner, called a single photon emission computed tomography scanner, to see how much dopamine is in your brain. This test can’t tell you for sure that you have Parkinson’s disease, but it can give your doctor more information to work with.
It can take a long time for some people to get a diagnosis. You may need to see your neurologist regularly so they can keep an eye on your symptoms and eventually figure out whatâs behind them.
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What Causes Parkinsons Disease
We do not know what causes Parkinsons disease. There is some evidence to suggest that there is a genetic factor which increases the risk of Parkinsons disease within some families. Also, there might be an increased risk if people have come into contact with a particular toxin or toxins found in the environment via pesticides and other chemicals used in agriculture. The specific toxin or toxins have not yet been identified but there is ongoing research into this possible cause.
What Happens During An Mri Scan
Whilst MRI equipment can look quite frightening, its a non-invasive technique that is performed safely on individuals every day in hospitals or radiology centers across the USA and throughout the world. .
- The patient is asked to lie down on a table which is then moved into a large tubular scanner.
- Typically the individual will be asked to avoid eating or drinking anything for a specific period of time prior to the scan taking place.
- A contrast dye may be injected into a vein to show up certain areas of the body more clearly.
- The scan normally takes about an hour but this may vary depending on what the patient is being tested for.
What Doctors Look For When Diagnosing Parkinsons
Certain physical signs and symptoms noticed by the patient or his or her loved ones are usually what prompt a person to see the doctor. These are the symptoms most often noticed by patients or their families:
Shaking or tremor: Called resting tremor, a trembling of a hand or foot that happens when the patient is at rest and typically stops when he or she is active or moving
Bradykinesia: Slowness of movement in the limbs, face, walking or overall body
Rigidity: Stiffness in the arms, legs or trunk
Posture instability: Trouble with balance and possible falls
Once the patient is at the doctors office, the physician:
Takes a medical history and does a physical examination.
Asks about current and past medications. Some medications may cause symptoms that mimic Parkinsons disease.
Performs a neurological examination, testing agility, muscle tone, gait and balance.
Read Also: Parkinson Disease Hereditary Factors
Parkinson’s Disease Early Stages Detected With ‘simple’ Mri Up To 85% Accurate
Detecting a life-threatening disease could give researchers the power of earlier diagnosis, treatment approaches, and innovative therapies a power that could one day possibly lead to cure a disease like Parkinsons. Researchers from Oxford University published their findings in the journal of Neurology, which reveal a promising new diagnostic approach for the early stages of Parkinsons disease.
At the moment we have no way to predict who is at risk of Parkinson’s disease in the vast majority of cases, said Dr. Clare Mackay, the studys co-author and professor of the Department of Psychiatry at Oxford University. Oxford researchers are turning the tables on that bleak risk evaluation now that they have developed an expediently simple technique to diagnose early Parkinsons stages with a magnetic resonance imaging machine with 85 percent accuracy. A normal MRI scan cannot detect the early signs, which is why researchers used restating state functional MRI to look at how strong the brain connections were in the basal ganglia, where important dopamine nerves are located.
We think that our MRI test will be relevant for diagnosis of Parkinson’s, said Dr. Michele Hu, the studys co-author and professor of the Nuffield Department of Clinical Neurosciences at Oxford University and the Oxford University Hospitals NHS Trust.
Mri Scans Can Show Dementia
According to researchers from Perelman School of Medicine at the University of Pennsylvania, the answer to can an MRI detect dementia is to some extent yes.
The scientists explained that doctors have an easier time telling whether a person has dementia through MRI scans.
This gets rid of the need to carry out invasive tests that people find unfriendly like the lumbar puncture where a doctor must stick a needle in the spine.
Additionally, it also helps to speed up the diagnosis process which is important seeing that dementia diagnosis for the longest time has been a struggle for medics often leading to delayed treatment.
In addition to telling whether a person has dementia, MRI scans may in the future help doctors determine whether an individual is at risk of dementia according to new research.
Research from the University of California San Francisco and the Washington University School of Medicine in St. Louis conducted a small study where MRI brain scans were able to predict with 89% accuracy the people who were going to develop dementia in three years.
The researchers presented their findings in Chicago during a Radiological Society of North America meeting.
It suggested that in a few years, physicians will be able to tell people their risk of developing dementia before they start to showcase any symptoms of the neurodegenerative illness.
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Imaging Studies Can Differentiate Parkinsons From Other Causes Of Parkinsonism
Catherine L. Gallagher, MD
Although Parkinsons disease remains a clinical diagnosis, imaging studies are an important ancillary test for differential diagnosis of movement disorders. Imaging studies may be used to rule out structural and other causes of parkinsonian symptoms. Single-photon emission computed tomography scans using labeled tracers for dopamine transporters can also be used to confirm parkinsonism or differentiate PD from secondary causes of parkinsonian motor symptoms. Finally, imaging studies are being used in research to better understand the pathophysiology of PD and elucidate causative mechanisms that could be therapeutic targets in the future.
New Diagnostic Standards For Parkinsons
Until recently, the gold-standard checklist for diagnosis came from the U.K.s Parkinsons Disease Society Brain Bank. It was a checklist that doctors followed to determine if the symptoms they saw fit the disease. But thats now considered outdated. Recently, new criteria from the International Parkinson and Movement Disorder Society have come into use. This list reflects the most current understanding of the condition. It allows doctors to reach a more accurate diagnosis so patients can begin treatment at earlier stages.
Determining Diagnosis Through Response To Parkinsons Medication
If a persons symptoms and neurologic examination are only suggestive of Parkinsons disease or if the diagnosis is otherwise in doubt, the physician may, nevertheless, prescribe a medication intended for Parkinsons disease to provide additional information. In the case of idiopathic Parkinsons, there is typically a positive, predictable response to Parkinsons disease medication in the case of some related Parkinsonian syndromes, the response to medication may not be particularly robust, or it may be absent entirely.
Unfortunately, there are no standard biological tests for the disease, such as a blood test. However, researchers are actively trying to find biomarkers in blood and other bodily fluids that could help confirm the diagnosis.