Diagnosing Parkinson's Disease & Movement Disorders 

Accuracy and efficiency are our top priorities when diagnosing movement disorders. Whenever possible, our physicians coordinate testing in a one-day outpatient visit.

At the first appointment, our specialists administer thorough assessments of your:

  • Symptoms

  • Medical history

  • Physical exam

  • Neurological exam

  • Imaging tests (as needed)

  • Genetic tests (as needed)

  • Lifestyle and behaviors

  • Family history of movement disorders

It can be difficult to pinpoint a diagnosis among the many types of movement disorders. For example, several disorders have symptoms similar to Parkinson's disease but may require different treatment.

Our team is proficient in the use of DaTscan imaging to help accurately diagnose movement disorders. DaTscan is a molecular imaging method that helps physicians understand how much neurodegeneration has occurred in the brain.

Following evaluation and testing, our physician team collectively reviews results and determines the diagnosis. In some cases, we may observe a patient’s response to medication to confirm the diagnosis.

Parkinson’s disease (PD) is a degenerative disease of the nervous system that causes impaired or involuntary movements and can affect behavior, mood and other non-motor functions of the body. PD is a progressive disease, meaning it worsens over time. Diagnosis usually occurs after age 55, though early onset at a younger age is also possible.

Parkinson's disease is caused by the progressive loss of a certain type of neuron cells in the brain. This results in a shortage of the chemical messenger called dopamine, which is important for controlling the body’s motor functions.

Symptoms

Parkinson's disease is characterized by:
  • Tremor, most commonly starting in the hands but can also occur in the tongue, jaw and legs
  • Stiff or rigid muscles (spasticity)
  • Slow movement (bradykinesia)
  • Decreased vocal volume
  • Lack of facial expression
  • Abnormally small handwriting (micrographia)
  • Shuffling gait (an impaired walk, as if the feet are stuck to the floor)
  • Decreased arm movement when walking
  • Difficulty with balance, posture or gait, which may result in falls

PD symptoms can often be controlled with medication alone, or with a combination of medication and surgical intervention, such as deep brain stimulation (DBS), for patients who meet certain criteria. The extent to which symptoms can be reduced depends on each patient’s individual circumstances. At UChicago Medicine, our goal is to improve symptoms so our patients can enjoy the highest possible quality of life.

Essential tremor, also known as benign familial tremor, is the most common movement disorder. Characterized by uncontrollable shaking, essential tremor progresses slowly. It is distinctly different from Parkinson’s disease, although commonly misdiagnosed. Some patients may have essential tremor and PD.

Symptoms

  • Difficulty with precise tasks (threading a needle)
  • Excessive shaking in hands
  • Inability to dress or feed yourself 
  • Shaking in tongue
  • Shaking in arms
  • Tremor in voice
  • Tremor in neck

Treatment plans for essential tremor may involve medication, surgery or a combination of both. Initial treatment often includes propranolol or primidone, which are medications that have proven effective in about half of patients. Deep brain stimulation (DBS) surgery is a highly effective treatment option for patients who are eligible candidates.

Symptoms

Movement disorder symptoms vary by specific diagnosis and gradually increase. Some common indications for potential further examination may include recurrence of:

  • Abnormal movement 
  • Abnormal posture
  • Difficulty in walking
  • Excessively slow walking
  • Frequent falls
  • Involuntary movement
  • Loss of balance

  • Muscle spasms

  • Stiffness

  • Tremor
  • Twitches
  • Lack of coordination

Causes

The underlying causes of movement disorders vary by diagnosis and sometimes remain unknown. Factors that may potentially influence the development of movement disorders include infections, inflammation, stroke, toxins, trauma, metabolic disorders, autoimmune diseases, genetic diseases and reactions to certain medications. It is believed that heredity and environmental triggers also play important roles in development of movement disorders.

Significant progress in research has been made to pinpoint exactly why these diseases and changes occur to discover effective treatments for the root causes of these diseases. Researchers at UChicago Medicine conduct rigorous clinical and laboratory investigations into common and rare movement disorders. We also closely monitor medical progress throughout the world to help benefit patients.

In Parkinson’s disease, production of a chemical in the brain called dopamine decreases due to the progressive loss of brain cells that produce it. These cells are lost mainly because of an abnormal accumulation of a protein called alpha-synuclein. Understanding what makes the alpha-synuclein protein accumulate in these brain cells is a major focus of PD research.