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Parkinson Disease


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How does one diagnose Parkinson Disease and what is the prognosis?



How is Parkinson's Disease Diagnosed?

There are currently no blood or laboratory tests that have been proven to help in diagnosing sporadic Parkinson Disease.  Therefore the diagnosis is based on medical history and a neurological examination.  The disease can be difficult to diagnose accurately.  Early signs and symptoms of Parkinson Disease may sometimes be dismissed as the effects of normal aging.  The physician may need to observe the person for some time until it is apparent that the symptoms are consistently present.  Doctors may sometimes request brain scans or laboratory tests in order to rule out other diseases. However, CT and MRI brain scans of people with Parkinson Disease usually appear normal.  Since many other diseases have similar features but require different treatments, making a precise diagnosis as soon as possible is essential so that patients can receive the proper treatment.

What is the Prognosis?

Parkinson Disease is not by itself a fatal disease, but it does get worse with time.   The average life expectancy of a Parkinson Disease patient is generally the same as for people who do not have the disease.  However, in the late stages of the disease, Parkinson Disease may cause complications such as choking, pneumonia, and falls that can lead to death.  Fortunately, there are many treatment options available for people with Parkinson Disease.

The progression of symptoms in Parkinson Disease may take 20 years or more.  In some people, however, the disease progresses more quickly.  There is no way to predict what course the disease will take for an individual person.  One commonly used system for describing how the symptoms of Parkinson Disease progress is called the Hoehn and Yahr scale.

Hoehn and Yahr Staging of Parkinson's Disease

Stage one

Symptoms on one side of the body only.

Stage two

Symptoms on both sides of the body.  No impairment of balance.

Stage three

Balance impairment.  Mild to moderate disease.  Physically independent.

Stage four

Severe disability, but still able to walk or stand unassisted.

Stage five

Wheelchair-bound or bedridden unless assisted.

Another commonly used scale is the Unified Parkinson's Disease Rating Scale (UPDRS). This much more complicated scale has multiple ratings that measure mental functioning, behavior, and mood; activities of daily living; and motor function. Both the Hoehn and Yahr scale and the UPDRS are used to measure how individuals are faring and how much treatments are helping them.

With appropriate treatment, most people with Parkinson Disease can live productive lives for many years after diagnosis.

National Institute of Neurological Disorders and Stroke (NINDS)
National Institutes of Health
Brain Resources and Information Network

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