Parkinson’s disease is the second most common neurodegenerative disease, with Alzheimer’s disease being the first. Approximately 1 million people in the United States are affected by Parkinson’s disease. Fifty thousand new cases are diagnosed annually. It is an age related disorder with a population incidence of 1-2% in the 60-70 year old age group, going up to 3% in those over 80. Early recognition of symptoms of PD and starting treatment soon afterwards is critical in maintaining the longest quality of life in these patients. Starting treatment early in Parkinson patients may significantly improve long-term outcomes, maintaining patient independence. Early, appropriate therapy can also lessen the need for assisted care and admissions to nursing homes. Disability from Parkinson’s disease can also be slowed down and limited to a degree.

Diagnosis of Parkinson Disease

Parkinson’s is a clinical diagnosis. There is no lab test, CT scan or MRI to make the diagnosis. To make a proper diagnosis of PD a qualified physician needs to do a detailed history and physical exam. There are 4 main clinical hallmarks in Parkinson’s: 1) Bradykinesia or slowness of movement, 2) Postural imbalance, gait unsteadiness; 3) Rigidity or feeling of lead-like stiffness; 4) Tremor at rest. To make the accurate diagnosis of Parkinson’s disease, one must have 3 of 4 of the hallmarks of this disorder. It should be noted that one-third of all PD patients do not have tremor. The converse is true: Not everything that shakes is Parkinson’s disease. Parkinson’s is a constellation of symptoms, a syndrome which requires that a physician be familiar with the clinical presentation of this disease. Parkinson patients have a characteristic blank facial expression, the Parkinson facies.

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