Parkinson's and Movement Disorders Program
Diagnosing Movement Disorders
Making an accurate diagnosis in the early stages of Parkinson's disease (PD) and other movement disorders can be difficult. The beginning signs and symptoms may be similar to those related to many other conditions or to the effects of normal aging. For this reason, observation of the patient may be required for some time until the symptoms are consistently present.
Diagnosis of PD and other movement disorders is based primarily on a medical history and thorough physical and neurological examination. Brain scans like the DaTSCAN™ and/or lab tests may be performed to help rule out other diseases or conditions.
Methods to assist movement disorder neurologists with the diagnosis of movement disorders include:
This examination includes evaluation of symptoms and their severity.
Trial test of drugs
When symptoms are significant, a trial test of drugs may be used to further diagnose the presence of PD. If a patient fails to benefit from the medication, a diagnosis of Parkinson's disease may be questionable.
An important component of successful medication treatment is working with patients to optimize effectiveness. For instance, “On/Off” testing is sometimes used for patients with Parkinson’s disease who are experiencing problems with symptom control. On/off testing involves monitoring the patient with and without the medication to determine the best level of symptom control.
Functional magnetic resonance imaging (fMRI)
An MRI is a non-invasive diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. fMRI can be used to provide information about brain activity if necessary.
Computed tomography scan, CT or CAT scan
A diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
This new, highly specialized brain scan aid offers physicians for the first time the ability to definitively determine whether or not a patient’s symptoms are related to Parkinson’s disease or related syndromes. In 2011, Froedtert & The Medical College of Wisconsin became the first in the state to offer this diagnostic advantage to patients. The earlier an accurate diagnosis of a movement disorder can be made, the sooner effective treatment can begin.
DaTSCAN™ is an FDA-approved substance used to detect the presence of dopamine transporters (DaT) in the brain, which would be low in patients with Parkinson’s disease or a parkinsonian syndrome. For the procedure, a patient receives an injection of the substance and then, a few hours later, undergoes a single-photon emission computed tomography (SPECT) scan that will show change in the brain’s chemistry. The test is painless and results are quickly available.
Date: May 16, 2012
Online Editor(s): Richard Petre