What is the best test for my doctor to order to diagnose Parkinson’s disease?
There is no reliable blood test to diagnose Parkinson’s disease. The best way to make a diagnosis is to have a neurological examination by someone experienced in the care of Parkinson’s disease patients. There are diagnostic criteria for the diagnosis of Parkinson’s disease (UK Brain Bank Criteria), which usually include:
I: Is Bradykinesia (slowness of movement present?
II: Are two of the below present?
___ Rigidity (Stiffness in arms, leg, or neck)
___ 4-6 Hertz resting tremor
___ Postural instability not caused by primary visual, vestibular, cerebellar, proprioceptive dysfunction
III: Are at least 3 of the below present?
___ Unilateral onset
___ Rest tremor present
___ Progressive disorder
___ Persistent asymmetry affecting side of onset most
___ Excellent response (70-100%) to levodopa
___ Severe levodopa induced dyskinesia
___ Levodopa response for 5 years or more
___ Clinical course of 5 years or more
Very rarely, there exists confusion about the diagnosis, and in these cases other tests such as Positron Emission Tomography, and Beta SPECT scanning (DAT) may be useful. (Hughes, Ben-Shlomo et al. 1992; Hughes, Daniel et al. 1992; Hughes, Daniel et al. 1993; Jankovic 2008; Jankovic and Aguilar 2008). DAT Scans have recently been approved by the FDA to differentiate Parkinson’s disease from essential tremor.
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