diagnosing Parkinson's disease

Last edited 04/2018 and last reviewed 11/2023

  • Parkinson's disease (PD) should be suspected in people presenting with tremor, stiffness, slowness, balance problems and/or gait disorders (1)

  • people with suspected PD should be referred quickly and untreated to a specialist with expertise in the differential diagnosis of this condition.
    • the referral time
      • for people with suspected mild PD should be no more than 6 weeks
      • in later disease with more complex problems should be within 2 weeks (2)

  • the diagnosis of PD should be reviewed regularly and re-considered if atypical clinical features develop

  • generally the diagnosis is based on history taking and physical examination
      • the commonly used clinical criteria for the diagnosis of PD are the UK Parkinson's Disease Society (PDS) Brain Bank Criteria

  • single photon emission computed tomography (SPECT) should be considered for people with tremor where essential tremor cannot be clinically differentiated from parkinsonism

  • structural MRI should not be used in the differential diagnosis of Parkinson's disease
    • however structural MRI may be considered for the differential diagnosis of parkinsonian syndromes

  • acute levodopa and apomorphine challenge tests should not be used in the differential diagnosis of parkinsonian syndromes

Review of diagnosis

  • review the diagnosis of Parkinson's disease regularly, and reconsider it if atypical clinical features develop. (People diagnosed with Parkinson's disease should be seen at regular intervals of 6-12 months to review their diagnosis) (1)

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