How To Check If You Have Parkinson Disease

Imaging And Lab Tests

Your doctor may order some imaging tests and laboratory tests. Imaging tests can include computed tomography scans and magnetic resonance imaging scans. Laboratory tests can include blood tests and urine tests.;

While these tests and scans will not help diagnose Parkinsons disease, they can help rule out other conditions that have similar symptoms.;

Your doctor may also suggest that you get a dopamine transporter scan . This scan requires a single-photon emission computed tomography scanner. It involves an injection of a small amount of a radioactive drug so that your doctor can study the dopamine systems in your brain .;

While a DaTscan cannot conclusively prove that you have Parkinsons, it can help confirm your doctors diagnosis and eliminate other conditions.;

Treatment Options For Early Onset Parkinsons Disease

Parkinsons treatment aims to slow the diseases progression. Medication treatment options may include the following:

• Levodopa is a chemical thats converted to dopamine in the brain. People with early onset Parkinsons may experience more negative side effects, such as involuntary movements.
• MAO-B inhibitors can help reduce the breakdown of dopamine in the brain.
• Catechol-O-methyltransferase inhibitors can help extend Levodopas effects on the brain.
• Anticholinergics can help reduce tremors.
• Amantadine may be used to improve muscle control and relieve stiffness.

Is Parkinsons Disease Inherited

Scientists have discovered gene mutations that are associated with Parkinsons disease.

There is some belief that some cases of early-onset Parkinsons disease disease starting before age 50 may be inherited. Scientists identified a gene mutation in people with Parkinsons disease whose brains contain Lewy bodies, which are clumps of the protein alpha-synuclein. Scientists are trying to understand the function of this protein and its relationship to genetic mutations that are sometimes seen in Parkinsons disease and in people with a type of dementia called Lewy body dementia.

Several other gene mutations have been found to play a role in Parkinsons disease. Mutations in these genes cause abnormal cell functioning, which affects the nerve cells ability to release dopamine and causes nerve cell death. Researchers are still trying to discover what causes these genes to mutate in order to understand how gene mutations influence the development of Parkinsons disease.

Scientists think that about 10% to 15% of persons with Parkinsons disease may have a genetic mutation that predisposes them to development of the disease. There are also environmental factors involved that are not fully understood.

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Parkinson’s Disease Can Be Prevented

There does not seem to be a way to predict or prevent Parkinson’s disease. Current research is investigating a biomarker â some kind of biological abnormality that would be present in patients with PD â that would be able to be detected from testing. This could help doctors identify people who are at-risk for developing Parkinson’s and thus find treatments to stop the disease process in the early stages or slow the progression. There are rare cases of genetically inherited PD where researchers can test for these genetic biomarkers to determine a person’s risk for developing the disease.

What Causes Parkinson’s Disease

Parkinson’s disease is the result of the loss of the brain chemical dopamine. When nerve cells, called neurons, in an area of the brain that controls movement become impaired and/or die, the amount of dopamine they normally produce decreases. This loss of dopamine causes the movement problems seen in people with PD.

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Diagnosis Of Parkinson’s Disease

To diagnose Parkinsons, doctors will use a combination of diagnostic tests, physical exams, and a review of family and health history. In general, two of the four main physical symptoms must be present over a period of time for a Parkinsons diagnosis to be given.

If your primary care doctor believes you might have early onset of Parkinsons, they will refer you to a specialist like a neurologist or a movement disorder specialist for further tests.

Tips For Daily Living

If you are already living with Parkinsons disease, here are some tips to manage it:

• Exercise your brain. Read, work on crossword puzzle, do Sudoku, or engage in other activities that use your brain.
• Get moving. If you feel comfortable walking, swimming, or riding an exercise bike, go for itand try to do it on a regular basis.
• Try tai chi. We think of tai chi as a mind-body exercise, and it is, but it also has roots as a martial art in China. A 2012 study found that practicing tai chi helped people with moderate Parkinsons disease maintain stability and balance. And a 2014 study found that tai chi can help people reduce their risk of falling. It incorporates a flowing series of coordinated movements to help you maintain flexibility, strength and balance, and it can be easily adapted to meet your abilities.
• Practice yoga. You dont have to perform headstands or other physically challenging poses to get significant benefits from practicing yoga. You can improve your balance, mobility, flexibility, and strength with a form thats adapted for you.
• Find a support group. Whether you prefer an online support group or a group that meets in person, a support group can be an invaluable resource for helping you live with Parkinsons disease.

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How Is Parkinsons Disease Treated

There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.

What Is The Outlook For Persons With Parkinsons Disease

Although there is no cure or absolute evidence of ways to prevent Parkinsons disease, scientists are working hard to learn more about the disease and find innovative ways to better manage it, prevent it from progressing and ultimately curing it.

Currently, you and your healthcare teams efforts are focused on medical management of your symptoms along with general health and lifestyle improvement recommendations . By identifying individual symptoms and adjusting the course of action based on changes in symptoms, most people with Parkinsons disease can live fulfilling lives.

The future is hopeful. Some of the research underway includes:

• Using stem cells to produce new neurons, which would produce dopamine.
• Producing a dopamine-producing enzyme that is delivered to a gene in the brain that controls movement.
• Using a naturally occurring human protein glial cell-line derived neurotrophic factor, GDNF to protect dopamine-releasing nerve cells.

Many other investigations are underway too. Much has been learned, much progress has been made and additional discoveries are likely to come.

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Diagnosing Early Onset Parkinsons Disease

There is no single test to detect Parkinsons. A diagnosis may be difficult and take a while. The condition is usually diagnosed by a neurologist based on a review of your symptoms and a physical exam.

A DaTscan to visualize your brains dopamine system may help confirm diagnosis. Blood tests and other imaging tests, such as an MRI scan, dont diagnose Parkinsons. However, they may be used to rule out other conditions.

What Is The Treatment For Parkinson’s Disease

There is currently no treatment to cure Parkinson’s disease. Several therapies are available to delay the onset of motor symptoms and to ameliorate motor symptoms. All of these therapies are designed to increase the amount of dopamine in the brain either by replacing dopamine, mimicking dopamine, or prolonging the effect of dopamine by inhibiting its breakdown. Studies have shown that early therapy in the non-motor stage can delay the onset of motor symptoms, thereby extending quality of life.

The most effective therapy for Parkinson’s disease is levodopa , which is converted to dopamine in the brain. However, because long-term treatment with levodopa can lead to unpleasant side effects , its use is often delayed until motor impairment is more severe. Levodopa is frequently prescribed together with carbidopa , which prevents levodopa from being broken down before it reaches the brain. Co-treatment with carbidopa allows for a lower levodopa dose, thereby reducing side effects.

In earlier stages of Parkinson’s disease, substances that mimic the action of dopamine , and substances that reduce the breakdown of dopamine inhibitors) can be very efficacious in relieving motor symptoms. Unpleasant side effects of these preparations are quite common, including swelling caused by fluid accumulation in body tissues, drowsiness, constipation, dizziness, hallucinations, and nausea.

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What Happens At The Exam

If your doctor thinks you might have Parkinsonâs disease, theyll recommend that you see a specialist who works with nervous system issues, called a neurologist. One whoâs also trained in movement disorders, like Parkinsonâs, may be able to make the right diagnosis faster.

Your neurologist will probably want to see how well your arms and legs move and check your muscle tone and balance.

They may ask you to get out of a chair without using your arms for support, for example. They also may ask a few questions:

• What other medical conditions do you have now or have you had in the past?
• What medications do you take?
• Has your handwriting gotten smaller?
• Do you have trouble with buttons or getting dressed?
• Do your feet feel âstuckâ to the floor when you try to walk or turn?
• Do people say your voice is softer or your speech is slurred?

Tell your doctor if youâve noticed a change in your sense of smell or you have trouble with sleep, memory, or mood.

Parkinsonâs disease can look different from person to person. Many people have some symptoms and not others.

Gait & Balance Abnormalities

Parkinsons Disease Exam

Patients with Parkinsons disease can develop an alteration of the postural reflexes that causes instability in gait and balance control. Such alterations usually develop later in the course of the illness and are a major cause of disability, especially because of the high risk for falls that derives.

Using the exam to pick up postural instability is of the utmost importance for the management of patients with PD, since it will trigger either a medication adjustment or a physical therapy intervention both aimed at falls prevention.

We have three tests for this part of the PD exam:

1);;;; Standing up from a chair

2);;;; Free walking

3);;;; Provoked pull test maneuver for balance

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What Are Lewy Bodies

Lewy bodies are abnormal protein deposits found in the brain. Researchers do not know exactly why Lewy bodies form or what role they may play in Parkinson’s disease, but they seem to be linked to certain types of dementia associated with both PD and Alzheimer’s disease. Lewy body dementia is a degenerative disease and symptoms range from parkinsonian symptoms such as bradykinesia, rigidity, tremor, and shuffling walk, to symptoms similar to those of Alzheimer’s disease . Symptoms may fluctuate, even from day to day. In later stages patients may develop hallucinations.

How To Test For Parkinson’s Disease

This article was medically reviewed by Erik Kramer, DO, MPH. Dr. Erik Kramer is a Primary Care Physician at the University of Colorado, specializing in internal medicine, diabetes, and weight management. He received his Doctorate in Osteopathic Medicine from the Touro University Nevada College of Osteopathic Medicine in 2012. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine and is board certified.There are 10 references cited in this article, which can be found at the bottom of the page. This article has been viewed 35,437 times.

Parkinsons Disease is a progressive neurodegenerative disorder affecting both motor and non-motor abilities. It afflicts 1% of those over 60 years of age.XResearch sourceJOHN D. GAZEWOOD, MD, MSPH,D. ROXANNE RICHARDS, MD,KARL CLEBAK, MD, Parkinsons An Update, The American Family Physician, 2013 Feb 15;87:267-273 It is a progressive disorder of the central nervous system. PD is caused by a lack of dopamine, a chemical that helps the parts of your brain responsible for motor function communicate with each other. This condition often causes tremors, muscle stiffness, slowness, and poor balance. If you suspect that you, or someone you love, has Parkinsons, it is important to know how you can diagnose this condition. Begin by trying to identify symptoms of the disease at home, and then see your doctor for an appropriate medical diagnosis.

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The Diagnostic Criteria Used Today

In 2015, a Movement Disorder Society task force proposed a set of criteria that became known as the Movement Disorder Society United Parkinsons Disease Rating Scale , which includes non-motor symptoms in its criteria.9

The new criteria requires you to have slowness of movement, plus either a rest tremor or rigidity. It also requires that you do not meet any criteria in a list called absolute exclusion criteria. This list of symptoms indicates you most likely do not have PD or that you may have an atypical parkinsonism disorders that resemble Parkinsons disease but are ultimately different. If you meet any of those requirements, PD is ruled out. For example, one absolute exclusion criteria is if you are taking a drug that is known to cause Parkinsons-like side effects.

Next, you must meet at least two of the following four criteria:

• Dramatic improvement of motor symptoms when you take the gold-standard Parkinsons medication called levodopa
• The presence of dyskinesia as a result of taking levodopa dyskinesia is a possible side effect of levodopa among people with PD
• Rest tremor, meaning your tremor occurs when the body part is at rest
• Loss of smell, or if you have a test called MIBG scintigraphy and it indicates that you have autonomic dysfunction, which is when your autonomic nervous system doesnt work correctly, leading to issues with things like heart rate and blood pressure.

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.

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Tremor In Other Conditions

While tremor is a common symptom of Parkinsons, it can also be a symptom of other conditions, most notably essential tremor. The main difference between Parkinsons tremor and most other types of tremor is that in Parkinsons resting tremor is most common. Other conditions are usually characterized by action tremor, which tends to lessen at rest and increase when youre doing something, like trying to make a phone call or take a drink.

Tremors of the head and voice are also common in essential tremor but rare in Parkinsons.

How It All Fits Together

Diagnosing Parkinsons disease can be tricky. The process relies heavily on your doctors judgment. In addition, the causes and risk factors of Parkinsons are not entirely clear yet, which contributes to the difficulty in diagnosing this condition.

However, there have been efforts to try and detect this disease earlier. For instance, clinicians have started focusing more on prodromal symptoms, which are early symptoms that appear before movement-related difficulties begin.;

These symptoms include:

• Loss of smell, which can sometimes occur years before other symptoms
• Chronic constipation, without any other explanation
• Rapid eye movement behavior disorder, which causes sleep disturbances

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Assessing Level Of Rigidity

Doctors also look for rigidity by moving the joints in your elbows, wrists, knees, and ankles to see if there’s resistance. The resistance may be smooth or may appear as slight hesitations in movements, known as cogwheeling. This is sometimes made more obvious by the patient actively moving the opposite limb.

Physical And Neurological Examination

Your doctor will conduct a physical and neurological examination. This can involve observing your behavior, movements, and mental state and conducting tests or asking you to perform certain exercises.;

These are some of the symptoms of Parkinsons your doctor can determine visually:

• Fewer spontaneous movements or hand gestures
• Reduced frequency of blinking
• Tremors in your hands while they are at rest, often only in one hand
• Hunched posture or forward lean while walking
• Stiff movements

These are some of the exercises your doctor may ask you to do to evaluate your movements, balance, and coordination:

• Opening and closing your fist
• Tapping your fingers, toes, and heels
• Holding your arms out in front of you
• Moving your finger from one point to another
• Rotating your wrists or ankles
• Standing from a chair

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Consider The Age And Time Factor

Doctors also keep in mind other factors when diagnosing Parkinson’s. For instance:

• The disease is not common in people younger than 50.
• Diagnosing Parkinson’s can be tricky and may take time.
• Other diseases can cause similar symptoms. Your doctor will try to rule out other diseases that mimic Parkinson’s such as .;

Tips For Caring For Someone With Parkinsons Disease

Caring for a loved one with early onset Parkinsons can be difficult. If youre a caregiver for someone with this condition, its important that you remember your own emotional and physical health.

Not only are you dealing with a difficult diagnosis, youre also managing an increased number of responsibilities. Burnout is common in caregivers, so make sure youre checking in with your own needs.

The Michael J. Fox Foundation Center for Parkinsons Research recommends these tips for caregivers:

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