How is Parkinson's detected?

There is no blood test or other procedure which can provide a 100% certain diagnosis of Parkinson's. The diagnosis and differentiation of individual Parkinson's syndromes must initially take place using purely clinical methods, i.e. the neurologist listens to the patient's or their relatives' description of their symptoms and examines the patient. You just need experience to be able to classify correctly a Parkinson's syndrome so that the treatment concept is consistent. It is not in vain that within the field of neurology a subspeciality called "Parkinson's and movement disorders" has developed together with corresponding clinics specialising in the field of Parkinson's.

Imaging procedures to detect Parkinson's

Imaging procedures of the brain (Computed Tomography, Nuclear Spin Tomography, Sonography inter alia) have their significance primarily in terms of additional information in differentiating between the different Parkinson's syndromes. Findings for typical Parkinson's disease are normal from cranial computed tomography and nuclear spin tomography (MRT/MRI) of the brain. In the case of typical findings and disease progression therefore, an imaging procedure such as CCT or MRI are not absolutely necessary. However in the case of imposing gait disturbances, atypical symptoms and rapid progression, imaging procedures are essential

Imaging procedure - Computed Tomography

A computed tomography (CT) of the head provides X-ray images of the brain, the bones and the blood vessels. Magnetic Resonance Tomography (MRT/MRI) is the method of choice. The CCT is purely helpful to provide evidence of larger structural lesions or a normal pressure hydrocephalus. Nuclear Spin Tomography/MRT/MRI

Imaging procedure - Magnetic Resonance Tomography (MRT)

Another option for brain imaging is nuclear spin tomography (Magnetic Resonance Tomography, MRT). The tomograms (images in sections) are produced by a strong magnetic field and provide more exact images than computed tomography thus allowing even the smallest changes to be detected. It is helpful for differentiating other Parkinson's syndromes from Parkinson's disease.

Imaging procedure - ultrasound examinations

Other examination methods are ultrasound examinations (Doppler - sonography) of the blood vessel in the neck and head and of late also the brain tissue. In this way the doctor determines whether and how badly the vessels are blocked through arterial calcification or whether the flow of blood to the brain is normal. The examination is very helpful because many patients manifest a vascular type of Parkinson's syndrome, which must be treated differently. A particular pattern when examining the brain stem can provide valuable information for the overall evaluation in the early stages of diagnosis. An ultrasound examination of the heart (echocardiography shows changes to the heart, which may occur while taking dopamine agonists. With certain Parkinson's drugs it is a requirement that ultrasound examinations of the heart (echocardiograms) are carried out at yearly intervals. In the case of oedemas (accumulation of water) in the legs, echocardiograms are essential in order to differentiate between the side-effects from the Parkinson's medications and a heart disease.

Imaging procedure - Positron Emission Tomography (PET)

The PET allows, primarily in the framework of scientific research, the preclinical diagnosis of Parkinson's disease. However it is not available as a clinical application. However because of the high expenditure involved (radiochemists on locations, cyclotron equipment with high level of staff requirement, computer-intensive data evaluation etc.) there are no data available on the sensitivity and specificity for a broad clinical application.