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Diagnosis of Parkinson’s Disease
There are no lab tests to definitively diagnose Parkinson's disease . Your doctor will ask about your medical history and do a thorough physical exam.
A neurological exam will include a range of tests to evaluate your strength, coordination, balance, and other aspects, such as:
- Muscle tone
- Rapid alternating movements
- Gait, posture
- Postural stability
- Quickness and precision of movement
- Observation of a tremor (during rest or activity)
A mini-mental status test may be done. Activities of daily living may also be evaluated, such as dressing, cutting and eating food, swallowing, hygiene, walking, and falls.
There are four symptoms that are considered hallmarks of Parkinson’s disease. These symptoms include:
- Tremor while at rest
- Slowness of movement (bradykinesia)
- Postural instability
Sometimes, not all of these hallmark symptoms are present. If that is the case, your doctor may examine you every few months to check on your symptoms.
Parkinson's disease may also cause:
- Blank facial expression
- Decreased eye blinking
- Stooped posture
- Sleep disturbances
- Shuffling gait
- Difficulty with initiating movement
- Difficulty rising from a sitting position
- Difficulties with activities of daily living
- Voice changes
- Swallowing difficulties and drooling
- Changes in handwriting
- Loss of smell
If your doctor has questions about the cause of your symptoms, you may be given tests to try to eliminate the possibility of other disorders. These tests may include:
Your doctor may also give you a trial of levodopa, a medication that increases the amount of dopamine your brain produces. A positive response to this medication may help to confirm the diagnosis.
Your doctor may also have imaging tests done, such as:
- SPECT scan—You will be given an injection of a substance that will make the pictures of your brain clearer. You will lie on a table, and a camera-like object will slowly rotate around you. This test may take about 90 minutes or longer. Your doctor may choose to use a specific type of scan, called dopamine transporter scan (DATscan), to evaluate your condition.
Parkinson disease. American Association of Neurological Surgeons website. Available at: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Parkinsons%20Disease.aspx. Accessed September 5, 2013.
Conn HF, Rakel RE. Conn’s Current Therapy 2002. 54th ed. Philadelphia, PA: WB Saunders Company; 2002.
Parkinson Disease. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/parkinsons%5Fdisease/parkinsons%5Fdisease.htm. Updated September 3, 2013. Accessed September 5, 2013.
Ravina B, Marek K, Eberly S, et al. Dopamine transporter imaging is associated with long-term outcomes in Parkinsons disease. Movement Disorders. 2012;27(11):1392-7.
Obeso JA, et al. Missing pieces in the Parkinson’s disease puzzle. Nature Medicine. 2010;16(6):653-661.
Parkinson's disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us. Updated August 27, 2013. Accessed September 5, 2013.
Should I get a DaTscan or PET scan to confirm my diagnosis of Parkinson’s disease? National Parkinson Foundation website. Available at: http://www.parkinson.org/Patients/Patients---On-The-Blog/February-2011/Should-I-get-a-DaTscan-or-PET-scan-to-confirm-my-d. Updated February 1, 2011. Accessed Spetember 5, 2013.
Varrone A, Haldin C. New developments of dopaminergic imaging of Parkinsons disease. Q J Nucl Med Mol Imaging. 2012:56:68-82.
9/3/2014 DynaMed's Systematic Literature Surveillance. Available at: http://www.ebscohost.com/dynamed: Wippold FJ, Cornelius RS, et al. American College of Radiology (ACR) Appropriateness Criteria for dementia and movement disorders. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/DementiaAndMovementDisorders.pdf. Updated 2014. Accessed September 3, 2014.
- Reviewer: Rimas Lukas, MD
- Review Date: 09/2013
- Update Date: 09/03/2014