Diagnosis and course of Parkinson’s disease

In order to diagnose Parkinson’s disease, the patient and their relatives are usually interviewed first. Among other things, it is about the time of onset of the symptoms and possible impairments in digestion, elimination and sexual function. In order to enable a reliable diagnosis, the doctor then carries out various medical examinations. If the disease is already in an advanced stage, Parkinson’s can often be recognized at first glance due to its typical symptoms.

Imaging procedures

During the examination, the doctor will first check whether the typical symptoms that indicate Parkinson’s disease are present: These include slowing of movement, tremor at rest, muscle stiffness and a posture that is bent over.

Imaging procedures can then enable a more precise diagnosis. With the help of magnetic resonance imaging ( MRI ) and  computed tomography  (CT), other diseases of the brain that lead to visible changes can be ruled out. A CT can be used, for example, to check whether a  brain tumor  or an old  stroke  is behind the symptoms.

An MRI, on the other hand, is usually used when the doctor treating you suspects an atypical Parkinson’s syndrome. In individual cases, procedures can also be used with which disorders of the dopamine metabolism in the brain can be detected.

The levodopa test

It is characteristic of many Parkinson’s patients that they initially react well to the administration of levodopa (L-dopa) – a precursor of  dopamine  . Therefore, patients suspected of having Parkinson’s are often given levodopa once to confirm the diagnosis. A dopamine antagonist should be taken one to two days before taking it to prevent unwanted side effects of levodopa such as  nausea  or vomiting.

If the symptoms improve after ingestion, this is a clear sign of Parkinson’s disease. Since the dosage of levodopa for the test is usually very high and therefore more severe side effects can occur, the test is often carried out under medical supervision.

Parkinson’s: course and prognosis

In general, Parkinson’s disease progresses slowly – how quickly the symptoms worsen varies from person to person. The earlier adequate treatment is started, the more life expectancy can be extended and the quality of life improved.

The life expectancy of Parkinson’s patients is usually only slightly below that of healthy people of the same age. In addition, after the onset of the disease, it can sometimes be more than 20 years before a Parkinson’s patient can no longer look after himself.

However, it is still the case that Parkinson’s disease cannot be cured. The progression of the disease cannot be stopped either, only slowed down. Therefore, Parkinson’s patients have an increased risk of one day being dependent on outside help due to physical limitations. The further the disease progresses, the more likely it is that complications will arise. These include falls, respiratory infections or swallowing disorders, which in the worst case can lead to death.

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