Diagnosing Parkinson's disease is often difficult, especially in its early stages. It has been estimated that nearly 40% of people with the disease may not be diagnosed, and as many as 25% are misdiagnosed. Even as the disease progresses, symptoms may be difficult to assess and may mirror other disorders. For example, tremor may not be apparent while a person is sitting or posture changes may be written off as osteoporosis or simply a sign of aging. Some doctors, who think that tremor is a requirement for diagnosis, may not realize that as many as a third of people with Parkinson's disease may not have tremor.
Furthermore, making the diagnosis is even more difficult since there are currently no sophisticated blood or lab tests available to diagnose the disease. Some tests, such as a CT Scan (computed tomography) or MRI (magnetic resonance imaging), may be used to rule out other disorders that cause similar symptoms. Given these circumstances, a doctor may need to observe the patient over time to recognize signs of tremor and rigidity, and pair them with other characteristic symptoms. The doctor will also compile a comprehensive history of the patient's symptoms, activity, medications, other medical problems, and exposures to toxic chemicals. This will likely be followed up with a rigorous physical exam with concentration on the functions of the brain and nervous system. Tests are conducted on the patient's reflexes, coordination, muscle strength, and mental function. Making a precise diagnosis is essential for prescribing the correct treatment regimen. The treatment decisions made early in the illness can have profound implications on the long-term success of treatment.
Why did I develop Parkinson's disease?
What are my treatment options?
What are the pros and cons of each treatment?
What short-term and long-term side effects can I expect from the treatment? Is there anything I can do to minimize them?
Can you recommend any support groups for my family and me?
Are there any non-drug options that might help? What lifestyle modifications can I...
Because the diagnosis is based on the doctor's exam of the patient, it is very important that the doctor be experienced in evaluating and diagnosing patients with Parkinson's disease. If Parkinson's disease is suspected, you should see a specialist, preferably a movement disorders trained neurologist.