Parkinson's disease is primarily diagnosed through a medical history review, symptom assessment, and a neurological and physical exam. There is no single definitive test, but doctors look for key symptoms such as bradykinesia (slowness of movement), tremor, rigidity, and balance problems to make the diagnosis. Additional tests like blood and lab work can help rule out other conditions. Imaging tests such as MRI or DaTscan (dopamine transporter scan) may be used to support the diagnosis or rule out other disorders. Newer diagnostic methods include genetic testing and tests for alpha-synuclein protein in the skin or spinal fluid, which are emerging tools for early detection. In some cases, a trial of Parkinson’s disease medication may be used to see if symptoms improve, helping to confirm the diagnosis.
The physical exam for Parkinson's specifically tests for the presence of bradykinesia along with either tremor, rigidity, or gait and balance abnormalities. Assessing muscle tone, observing spontaneous movements, and testing coordination and reflexes are part of this exam. Some rigidity types can be identified by passive limb movements and activation maneuvers during the exam.
In summary, diagnosis involves clinical evaluation by a neurologist or movement disorder specialist, supported by selective imaging and lab tests, with emerging biomarker tests offering potential for earlier and more precise diagnosis.
