The Challenges of Diagnosing PD
Diagnosing Parkinson’s disease can be challenging, especially during the early stages. Nearly 40% of people with the disease may never be diagnosed, and as many as 25% are misdiagnosed. Even during disease progression, symptoms may be difficult to evaluate and may reflect other disorders. A tremor may not be obvious while a person is sitting or posture changes may appear as osteoporosis or merely a sign of aging. Some doctors, who feel that tremor is a requirement for diagnosis, may not know that as many as one third of people with Parkinson’s disease may not experience tremor.
Additionally, making the diagnosis is even more difficult because currently there are no blood or lab tests available to diagnose the disease. Some tests, such as a CT scan or MRI (magnetic resonance imaging), may be utilized to rule out other disorders that cause similar symptoms. Given these conditions, a doctor may need to observe the patient over time to distinguish signs of tremor and rigidity, and combine them with other typical symptoms. The doctor will also accumulate a complete history of the patient’s symptoms, activity, medications, other medical problems, and exposures to toxic chemicals. This will typically be followed up with an arduous physical exam with focus on the functions of the brain and nervous system. Tests are performed on the patient’s reflexes, coordination, muscle strength, and mental function. Making a clear-cut diagnosis is vital for prescribing the correct treatment procedure. The treatment decisions made early in the illness can have profound repercussions on the long-term success of treatment.
Because the diagnosis is based on the doctor’s exam of the patient, it is crucial that the doctor be experienced in evaluating and diagnosing patients with PD. If you suspect you have PD, you should see a specialist, if possible a movement disorders trained neurologist.