Dr. Rajesh Pahwa 00:00:05
The way Parkinson's disease is diagnosed is a clinical diagnosis. By which I mean that the physician usually takes a history and performs an examination. We usually don't do any tests, such as a brain scan like an MRI of the brain, unless there is a certain reason the physician feels an MRI is needed.
To make an assessment that they have features of parkinsonism, a patient has to have at least two out of these three present: tremor, slowness or bradykinesia, or rigidity. Once that is established, a physician usually assesses that there are not any other reasons or other neurological findings. In addition, the physician usually will assess that the presentation is not atypical, by which I mean that the symptoms did not begin with an atypical symptom such as falling.
Dr. Rajesh Pahwa 00:01:09
Finally, we look at certain other characteristics, such as: Did the symptoms begin on one side? Did the patient have a tremor when they were just resting, which is called a resting tremor? A resting tremor starting on one side is the most common presentation for Parkinson's disease. We often assess: Have the symptoms progressed over time? We assess if they have been on medications, not only whether they have responded well to the medications, but if a patient has developed any involuntary movements due to their medications.
Taking all this together, a physician will come to a clinical diagnosis of Parkinson's disease.