Abstract

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.

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