Standard strategies for diagnosis and treatment of patients with newly diagnosed Parkinson disease
UNITED STATES
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Special clues to diagnosis of idiopathic Parkinson disease (PD) are asymmetric onset, resting tremor, and an objective, robust response to treatment with l-dopa. Brain MRI is used to exclude rare structural causes of parkinsonism. Ceruloplasmin levels to exclude Wilson disease and thyroid function tests are appropriate in some patients. Dopamine uptake scans, or DaTscans, are now available in the US for diagnosis of PD. Currently DaTscan technology in the US is not able to estimate duration or severity of PD. These tests also do not differentiate idiopathic PD from atypical parkinsonism and are used mainly when there is uncertainty concerning diagnosis, for example, in patients in whom drug-induced or arteriosclerotic parkinsonism may simulate PD.
Footnotes
Study funding: No targeted funding reported.
Disclosures: D. Tarsy has received speaker honoraria from UCB Pharma and the International Movement Disorders Society; receives publishing royalties from UpToDate and for Movement Disorders: A Video Atlas (Springer 2012); serves as a consultant for Genzyme and Neurocrine Biosciences; receives research support from Phytopharm PLC and the National Parkinson Foundation; and has participated in medicolegal proceedings. Full disclosure form information provided by the author is available with the full text of this article at Neurology.org/cp.
- © 2013 American Academy of Neurology
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