Parkinson’s Disease: Diagnosis and Treatment

Diagnosis

Parkinson’s disease is usually diagnosed clinically when an experienced neurologist observes the characteristic physical and neurologic symptoms. There are no tests to definitively confirm the disease but testing, such as a CT scan, MRI, or spinal tap, may be useful to rule out other diseases.

If the diagnosis is in doubt, a doctor may begin a trial of a Parkinson’s medication to see if it improves symptoms. If so, Parkinson’s disease is diagnosed.

Treatment

There is no known cure for Parkinson’s, but medical and nutritional therapies can decrease the symptoms and may slow the course of the disease.

The first step is to eliminate any drugs or medications that may be causing symptoms of Parkinson’s disease. These include antinausea medications, antipsychotic medications, reserpine, and others.

The most common medical drugs used to treat Parkinson’s disease are medications that mimic the effects of dopamine in the brain, most commonly levodopa (Sinemet). Other medications may also be useful, including bromocriptine, pergolide, entacapone, tolcapone, and selegeline.

Medications are also available to treat some of the specific symptoms of Parkinson’s disease. For example, benztropine may be effective to treat tremors. Clozapine or quetiapine may decrease hallucinations.

Physical, occupational, and speech therapies are usually very helpful for patients to improve activities of daily living, achieve or maintain independence, and interact better with their environment. Outside of therapy sessions, patients should try to maintain as active a lifestyle as possible.

There has been some coverage in the media of surgical treatments for Parkinson’s disease. While these may be helpful in treating advanced disease or in patients with specific symptoms (such as severe tremor or rigidity), they are not considered useful for most patients.