A recent article from a newspaper in Korea lamented that a high percentage of Koreans with Parkinson's are not properly diagnosed. Misdiagnosing Parkinson's disease is not just a Korean issue. It happens all over the world, and even at the hands of the most spectacular movement disorders specialists. Diagnosing brain and nerve disorders is challenging, and it is not a perfect science. There are a number of Parkinsonisms that are similar to Parkinson's disease.
Failing to Diagnose Parkinson's Disease
How is Parkinson's disease diagnosed? A patient with a resting tremor, bradykinesia (slowness of movement), or rigidity might capture the attention of a physician. If a physician observes two of these symptoms occurring together, he or she will often pronounce a diagnosis of PD. The doctor often prescribes levodopa, an MAO inhibitor, or a dopamine agonist. If these medications cancel out some of the symptoms, it further confirms the diagnosis.
There are no FDA approved blood tests, CT scans, or MRIs to diagnose Parkinson's disease. (There are some in clinical trials that are promising.)
Sometimes there are mistakes in the process. Sometimes a doctor will see a slight tremor and dismiss it as essential tremor. There are also instances when bradykinesia or rigidity are mistaken for injuries, fatigue, or many other conditions.
Mistakenly Pronouncing a Parkinson's Disease Diagnosis
Symptoms of an emotional condition like nervousness or anxiety, mimic tremors and rigidity. As a matter of fact, there are a number of conditions that produce tremors, slowness, and stiffness. Many of these are physical conditions that affect muscles and nerves. Physicians sometimes declare a diagnosis of Parkinson's disease when it is something else. This is not a criticism, it is a fact of the complex world of neurology.
A few months or years after declaring the Parkinson's disease diagnosis, a physician may notice symptoms that make him or her think the patient has something else. If a patient doesn't improve with Parkinson's disease medications, that is often the first hint that it is not Parkinson's disease. Three of the most common diseases mistaken for Parkinson's disease are Lewy body disease, progressive supranuclear palsy, and multiple system atrophy.
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