To diagnose Parkinson’s disease, the first step is usually to interview the patient and family members. Among other things, this involves the onset of symptoms over time and possible impairments in digestion, elimination, and sexual function. To enable a reliable diagnosis, the physician then performs various medical examinations. If the disease is already in an advanced stage, Parkinson’s can often be recognized at first glance due to its typical symptoms.
Imaging procedures
During the examination, the physician will first check whether the typical symptoms that indicate Parkinson’s disease are present: These include a slowing of movement, a resting tremor, stiffness of the muscles, and a posture that leans forward.
Imaging techniques can then provide a more accurate diagnosis. For example, magnetic resonance imaging (MRI) as well as computed tomography (CT) can be used to rule out other diseases of the brain that cause visible changes. For example, a CT can be used to check whether a brain tumor or an old stroke is behind the symptoms.
An MRI, on the other hand, is usually used if the treating physician suspects an atypical Parkinson’s syndrome. In individual cases, procedures can also be used to detect disorders of dopamine metabolism in the brain.
The levodopa test
Characteristically, many Parkinson’s patients initially respond well to administration of levodopa (L-dopa)-a precursor of dopamine. That’s why patients suspected of having Parkinson’s are often given a single dose of levodopa to confirm the diagnosis. A dopamine antagonist should be taken one to two days before the levodopa is administered to prevent unwanted side effects of levodopa such as nausea or vomiting.
If symptoms improve after taking levodopa, this should be taken as a clear sign of Parkinson’s disease. Since the dosage of levodopa for the test is usually very high and stronger side effects can occur because of this, the test is often performed under medical supervision.
Parkinson’s disease: course and prognosis
In general, Parkinson’s disease takes a slowly progressive course – how quickly the symptoms worsen varies from individual to individual. The earlier adequate treatment is started, the more life expectancy can be extended and quality of life improved.
In most cases, the life expectancy of Parkinson’s patients is only minimally lower than that of healthy people of the same age. Moreover, after the onset of the disease, it can sometimes take more than 20 years before a Parkinson’s patient is no longer able to care for himself independently.
However, it is still the case that Parkinson’s disease cannot be cured. The progression of the disease cannot be stopped, but only slowed down. Therefore, Parkinson’s patients have an increased risk of one day being dependent on outside help due to physical limitations. The more the disease progresses, the more likely it is that complications will occur. These include falls, respiratory infections or swallowing difficulties, which in the worst case can lead to death.
