Making the Diagnosis of Parkinson’s Disease

Parkinson’s disease is difficult to diagnose especially when the disease is in the early stage. The symptoms are mild in the early stage and may be easily masked. The person can learn to compensate or hide the early symptoms. It is easier to hope that what you may think is something wrong is just in your imagination and that it will all just go away. In fact, many of the individuals later diagnosed with Parkinson’s were first misdiagnosed and said to be just experiencing "natural signs of aging".

When early symptoms start to be noticed in someone of relatively young age (younger than 50) the symptoms are often overlooked, or dismissed because Parkinson’s is seen as a disease of those who are advanced in age…. therefore someone young can’t possibly have Parkinson’s disease, so the symptoms must mean something else, right? Age can sometimes confuse the diagnosis. Doctors must be careful not to make any assumptions when trying to diagnose someone who presents with tremors, stiffness, trouble writing, swallowing or speaking.

Doctors use many tools and techniques to arrive at a diagnosis including the medical history and history of symptoms, genetic testing, testing of the olfactory and autonomic system, neurophysiological testing and also neuroimaging.

Genetic testing uses mutations of genes that have been identified and used to help genetic counselors explain mutated genes and how likely they are to pass on the disease to their children.

Each person has a unique brain. There are several tests that show just how unique each brain is including PET scans which can show 3D images of the brain. PET scans can show the measurement of the amount of dompanime being released by the neurons. Two tests, the single-photon emission computed tomography (SPECT) and the radio labeled compound are used to measure the amount of dompanime releasing neurons.

It has been discovered that those with Parkinson’s disease have an impaired sense of smell. If we test how well a person can smell we may have an indicator of Parkinson’s.

Did you know that you have an autonomic system that regulates cardiovascular, digestive and respiratory functions? The autonomic system also regulates such body functions as salivating, perspiring, and the dilation of the pupils, the discharging of urine, and for males, having an erection. When these functions are known to be impaired, Parkinson’s is suspected. There is another disease; Multiple System Atrophy (MSA) that has many of the same symptoms as Parkinson’s which is why testing is so crucial to receiving the correct diagnosis. In order to make the correct diagnosis, your doctor will conduct a variety of tests, which can take time. The patient and the doctor must be patient and willing to take the time to make the correct diagnosis.

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