How to Diagnose?


I wasn't quite sure where to put this question but I was wondering what tests are done to diagnose Parkinson's?

I know neuros are looking for specific physical problems and that dopamine levels are checked (how?) but I was also wondering if they did MRIs of brain and spinal cord and what they were looking to find (flares, atrophy etc) Also wondered if they did nerve conduction tests or something similar?




the main tests for pd are fairly obvious- walking stiffly with little arm movement. cog-like ratcheting movement when turning the arm. loss of sense of smell. etc. there is a family of symptoms - you dont need them all but if you have a few... most cases are obvious, some are tricky.  mri is a negative test to rule out other causes.

datscan is a positive test that shows lack of dopamine producing cells and suggests either pd or the rarer msa.

if the patent responds well to levadopa it is almost certainly pd.




Just because I have to be a little difficult - when it comes to the ratcheting, do people normally experience it in the neck? Everything I have read mentions, usually, arms, but I don't know if patients actually experience this symptom elsewhere?


Don't know about "normally", but yes you can get a stiff neck. Doctors are always twisting mine around just like they manipulate wrists. And before I was dx, my nexk was so stiff i couldn't turn my head around to reverse a car. (All better for now.)



My reason for asking is that the main problem I had when I first went to the doctor, was that one morning I couldn't raise my head off the bed. I eventually managed it but it juddered into position. I did have neck pain - but that was all it got put down on my records as - which wasn't my concern really, it was the fact that for quite a few days when I tried to raise my head from a lying position I got this strange juddering. I (much) later realised that it corresponded to cogwheeling in limbs but as yet I have never had any clinician do any kinds of tests on my neck.

The funny thing is that this has happened for years but in a different scenario. When at the dentists and they tip the chair back, they usually ask at some point if you will sit up and spit into a cup (sorry!) but they don't raise the chair. When I did that, my head wouldn't come up in the same way and my neck would judder my head. It made me look very, very nervous - but it was a purely physical thing.

Maybe it's not related to Parkinson's, maybe I just have a weak neck!

And yes, I have trouble reversing. Turning my head to the left means it doesn't go very far at all.



i don't recognise the juddering, but the rest was common for me pre-dx. It seems there are plenty of hindsight-indicators, which at the time could each be summat or nowt and certainly don't mean you've got PD, but on reflection after dx fit into a pattern, and which themselves might be relieved by PD drugs: burning back pain, especially between the shoulder blades; frozen shoulder; etc.

It's good to be reminded how rubbish i was pre-dx, and how a couple of years on - even though some stuff is getting worserer again - I'm still largely better off.




i have a neck rest and  pillow under my legs at the dentist..difficulty lifting your head is a common problem.


ahem the neck rest is under my neck of course


I get the juddering in my neck, and it is a fairly recent symptom (part of my "progression"). Sometimes it judders when I'm not doing anything, esp when I'm tired. (BTW, I was dx end 2012 so it's still early days.)

I have osteoporosis, so at times I get a stiff neck just from turning it a certain way. A heat pack helps.


there is  huge variation in symptoms, yours might reflect the combination of both conditions. sometimes pd is misdiagnosed as osteoporosis. it will be interesting to see if it gets better when you are on levodopa