20th July 2023

Diagnosis

PD tends to be a clinical diagnosis, made through an extensive history and examination, ensuring that all secondary causes of Parkinsonism have been excluded. This includes prodromal features such as rapid eye movement, sleep disorders, hyposmia, typical motor symptoms and neuropsychiatric symptoms. Neurological examination may show cardinal motor signs of bradykinesia with tremor, rigidity or both. Typically, the diagnosis should only be made by a specialist. NICE recommends neurologist referrals before medication is started. Diagnosis is not concrete; it should be reviewed throughout an individual’s illness, especially if it takes an atypical course.

Imaging: A DaT (Dopamine Transporter) scan can be useful if the diagnosis is unclear. This involves using small quantities of a radioactive drug to determine how much dopamine is available in the CNS.