Parkinson’s diagnosis
From first symptoms to a clear answer
Waiting for a diagnosis can feel overwhelming. You may have noticed subtle changes in your body and are looking for answers. You are not alone, and understanding how Parkinson’s is diagnosed can help you feel more in control.
Diagnosing Parkinson’s disease is not done with one simple test. There is no blood test or scan that can give a clear “yes” or “no.” Instead, doctors diagnose Parkinson’s by listening carefully to your symptoms, examining how you move, and observing how things change over time.
The process works best when you and your medical team work together. Your observations matter. Your questions matter. And taking time is often part of making the diagnosis accurate.
Early symptoms and the first medical visit
For many, the journey begins with barely noticeable changes that develop gradually, often over years. You might notice a small shake in your hand, your handwriting becoming smaller (called micrographia), or simply feeling "stiff".
Your first stop is usually your General Practitioner. They will listen to your concerns and review your medical history. If they suspect your symptoms could be Parkinson’s, clinical guidelines recommend a prompt referral to a neurologist — a doctor who specializes in the brain and nervous system. Whenever possible, this is best done with a neurologist who has experience in movement disorders such as Parkinson’s.
How neurologists diagnose Parkinson’s
When you see a neurologist, they look for a specific pattern of symptoms. Doctors call this pattern "parkinsonism". To fit this pattern, two things must be present:
Bradykinesia (slowness of movement): This does not just mean moving slowly. Movements also become smaller and weaker each time you repeat them — for example, when tapping your fingers.
2. Plus one of the following:
Tremor: Shaking that happens when the hand or leg is relaxed.
Rigidity (stiffness): Muscles feel tight and do not fully relax.
Your medical history and physical exam are the most powerful tools a neurologist has. During your first appointment, the neurologist will examine:
Your movement and balance: The doctor will ask you to perform simple tasks, such as walking across the room, to observe your arm swing, posture, and stride. They may also perform a “pull test,” where they give a gentle tug on your shoulders to see how well you keep your balance.
Non-movement symptoms: The doctor will also ask about symptoms not related to movement. These are often called prodromal symptoms — early signs that can appear years before movement symptoms. Common examples include a reduced sense of smell (called hyposmia), chronic constipation, or physically acting out dreams during sleep (called REM Sleep Behavior Disorder).
If you are accompanying a loved one to their appointment, bring a list of symptoms you have noticed. Your perspective is important, and you may observe changes they have missed.
To help you prepare, we have created a simple checklist to help you gather all the necessary information for your first appointment with the neurologist. Click here to open it.
Why a Parkinson’s diagnosis often takes years to confirm?
You may be surprised to learn that it takes, on average, more than three years from the first symptom for a patient to receive a formal diagnosis. This happens, because Parkinson's develops slowly and quietly. Given that the diagnosis is primarily based on observation, a neurologist often needs a follow-up period to confirm the diagnosis, in order to see how your symptoms change over the years. In fact, accuracy is significantly higher after a person has been observed for five years compared to the very first visit. If your doctor says, "let’s wait and see," it is actually a sign of a careful, high-quality clinician.
Supportive tests
While the clinical exam is the "gold standard," other tests help rule out other conditions that look like Parkinson’s but have different causes. To support the diagnosis and rule out other conditions, your doctor may recommend the following tests:
MRI and CT scans: These look at the structure of the brain. In typical Parkinson’s, these scans are usually normal, but they help the doctor make sure your symptoms are not caused by a small stroke, a tumor, or fluid buildup in your brain.
Blood tests: Doctors often order blood tests during the diagnostic process. These tests do not confirm Parkinson’s disease. Instead, they help rule out other conditions that can cause similar symptoms, such as thyroid problems, low levels of vitamins, infections, or inflammation. Normal blood test results are common in Parkinson’s and are often reassuring, because they help narrow the diagnosis.
DaTscan is a special type of brain scan that shows how much dopamine activity there is in certain parts of the brain. It can help doctors see whether dopamine-producing brain cells are reduced, which often happens in Parkinson’s disease. A DaTscan is very useful for telling the difference between Parkinson’s and Essential Tremor. However, it cannot always tell Parkinson’s apart from other, more rare conditions that look similar.
The levodopa challenge: One of the ways doctors support a Parkinson’s diagnosis is by seeing how symptoms respond to medication. If movement, stiffness, or slowness clearly improve after starting levodopa, this supports the diagnosis of Parkinson’s disease. However, response to medication is not a yes-or-no test. Some people with early Parkinson’s improve only slightly at first, and doctors often need time and follow-up visits to be confident. In younger people with Parkinson’s (often called Young-Onset Parkinson’s disease-YOPD), doctors may choose to delay starting levodopa and use other treatments first, especially if symptoms are mild. For this reason, the levodopa response is not always used early in people with Young-Onset Parkinson’s.
Genetic testing: When it helps and when it does not
Genetic testing can be useful in specific cases, but it is not part of the routine diagnosis of Parkinson's disease for most people. Genetic testing is a special test that checks our genes, our "biological code," to see if there are changes associated with Parkinson's disease. The process of genetic testing is simple and non-invasive.
Is it suggested at diagnosis?
Not usually for everyone. It is typically recommended if you are young (under 50) or if several people in your family have the condition.
Can it confirm a diagnosis?
A gene test can show a link, but having a "Parkinson's gene" does not mean you will definitely get the disease. Its main benefit today is helping researchers find new treatments and seeing if you can participate in specific clinical trials.
New tests and Biomarkers: What’s coming next
Biomarkers are signals in the body that show disease or if a medicine is working. For a long time, we did not have one for Parkinson’s, but that is changing. In people with Parkinson's disease, a protein called α-synuclein, can clump together in the brain, forming what are called “aggregates ”. A new test called the α-Synuclein Seed Amplification Assay (SAA) can now find these aggregates in a person’s spinal fluid or skin. This test was found to be over 87% accurate at identifying Parkinson’s.
While SAA is a breakthrough, it is currently used mostly in research and clinical trials. It is a "yes or no" test but it does not yet tell us how fast the disease might progress or how severe the symptoms are. Scientists are working on turning this into a blood test to make it easier for everyone to access.
The future of Parkinson’s diagnosis
Today, Parkinson’s is diagnosed by carefully observing symptoms and how they change over time. The goal for the future is to diagnose the disease earlier, before movement symptoms appear.
The path to a clear diagnosis can take time, but you do not have to navigate it on your own. At Parkinson Pharos, we believe that knowledge builds confidence. Understanding the process, asking informed questions, and staying connected to reliable research can help you move forward with confidence and clarity.
If you are waiting for a diagnosis, or supporting someone who is, you are welcome to explore our personal stories and practical guides. We are here to support you.
Waiting for a diagnosis can feel overwhelming. You may have noticed subtle changes in your body and are looking for answers. You are not alone, and understanding how Parkinson’s is diagnosed can help you feel more in control.
Diagnosing Parkinson’s disease is not done with one simple test. There is no blood test or scan that can give a clear “yes” or “no.” Instead, doctors diagnose Parkinson’s by listening carefully to your symptoms, examining how you move, and observing how things change over time.
The process works best when you and your medical team work together. Your observations matter. Your questions matter. And taking time is often part of making the diagnosis accurate.
Early symptoms and the first medical visit
For many, the journey begins with barely noticeable changes that develop gradually, often over years. You might notice a small shake in your hand, your handwriting becoming smaller (called micrographia), or simply feeling "stiff".
Your first stop is usually your General Practitioner. They will listen to your concerns and review your medical history. If they suspect your symptoms could be Parkinson’s, clinical guidelines recommend a prompt referral to a neurologist — a doctor who specializes in the brain and nervous system. Whenever possible, this is best done with a neurologist who has experience in movement disorders such as Parkinson’s.
How neurologists diagnose Parkinson’s
When you see a neurologist, they look for a specific pattern of symptoms. Doctors call this pattern "parkinsonism". To fit this pattern, two things must be present:
Bradykinesia (slowness of movement): This does not just mean moving slowly. Movements also become smaller and weaker each time you repeat them — for example, when tapping your fingers.
2. Plus one of the following:
Tremor: Shaking that happens when the hand or leg is relaxed.
Rigidity (stiffness): Muscles feel tight and do not fully relax.
Your medical history and physical exam are the most powerful tools a neurologist has. During your first appointment, the neurologist will examine:
Your movement and balance: The doctor will ask you to perform simple tasks, such as walking across the room, to observe your arm swing, posture, and stride. They may also perform a “pull test,” where they give a gentle tug on your shoulders to see how well you keep your balance.
Non-movement symptoms: The doctor will also ask about symptoms not related to movement. These are often called prodromal symptoms — early signs that can appear years before movement symptoms. Common examples include a reduced sense of smell (called hyposmia), chronic constipation, or physically acting out dreams during sleep (called REM Sleep Behavior Disorder).
If you are accompanying a loved one to their appointment, bring a list of symptoms you have noticed. Your perspective is important, and you may observe changes they have missed.
To help you prepare, we have created a simple checklist to help you gather all the necessary information for your first appointment with the neurologist. Click here to open it.
Why a Parkinson’s diagnosis often takes years to confirm?
You may be surprised to learn that it takes, on average, more than three years from the first symptom for a patient to receive a formal diagnosis. This happens, because Parkinson's develops slowly and quietly. Given that the diagnosis is primarily based on observation, a neurologist often needs a follow-up period to confirm the diagnosis, in order to see how your symptoms change over the years. In fact, accuracy is significantly higher after a person has been observed for five years compared to the very first visit. If your doctor says, "let’s wait and see," it is actually a sign of a careful, high-quality clinician.
Supportive tests
While the clinical exam is the "gold standard," other tests help rule out other conditions that look like Parkinson’s but have different causes. To support the diagnosis and rule out other conditions, your doctor may recommend the following tests:
MRI and CT scans: These look at the structure of the brain. In typical Parkinson’s, these scans are usually normal, but they help the doctor make sure your symptoms are not caused by a small stroke, a tumor, or fluid buildup in your brain.
Blood tests: Doctors often order blood tests during the diagnostic process. These tests do not confirm Parkinson’s disease. Instead, they help rule out other conditions that can cause similar symptoms, such as thyroid problems, low levels of vitamins, infections, or inflammation. Normal blood test results are common in Parkinson’s and are often reassuring, because they help narrow the diagnosis.
DaTscan is a special type of brain scan that shows how much dopamine activity there is in certain parts of the brain. It can help doctors see whether dopamine-producing brain cells are reduced, which often happens in Parkinson’s disease. A DaTscan is very useful for telling the difference between Parkinson’s and Essential Tremor. However, it cannot always tell Parkinson’s apart from other, more rare conditions that look similar.
The levodopa challenge: One of the ways doctors support a Parkinson’s diagnosis is by seeing how symptoms respond to medication. If movement, stiffness, or slowness clearly improve after starting levodopa, this supports the diagnosis of Parkinson’s disease. However, response to medication is not a yes-or-no test. Some people with early Parkinson’s improve only slightly at first, and doctors often need time and follow-up visits to be confident. In younger people with Parkinson’s (often called Young-Onset Parkinson’s disease-YOPD), doctors may choose to delay starting levodopa and use other treatments first, especially if symptoms are mild. For this reason, the levodopa response is not always used early in people with Young-Onset Parkinson’s.
Genetic testing: When it helps and when it does not
Genetic testing can be useful in specific cases, but it is not part of the routine diagnosis of Parkinson's disease for most people. Genetic testing is a special test that checks our genes, our "biological code," to see if there are changes associated with Parkinson's disease. The process of genetic testing is simple and non-invasive.
Is it suggested at diagnosis?
Not usually for everyone. It is typically recommended if you are young (under 50) or if several people in your family have the condition.
Can it confirm a diagnosis?
A gene test can show a link, but having a "Parkinson's gene" does not mean you will definitely get the disease. Its main benefit today is helping researchers find new treatments and seeing if you can participate in specific clinical trials.
New tests and Biomarkers: What’s coming next
Biomarkers are signals in the body that show disease or if a medicine is working. For a long time, we did not have one for Parkinson’s, but that is changing. In people with Parkinson's disease, a protein called α-synuclein, can clump together in the brain, forming what are called “aggregates”. A new test called the α-Synuclein Seed Amplification Assay (SAA) can now find these aggregates in a person’s spinal fluid or skin. This test was found to be over 87% accurate at identifying Parkinson’s.
While SAA is a breakthrough, it is currently used mostly in research and clinical trials. It is a "yes or no" test but it does not yet tell us how fast the disease might progress or how severe the symptoms are. Scientists are working on turning this into a blood test to make it easier for everyone to access.
The future of Parkinson’s diagnosis
Today, Parkinson’s is diagnosed by carefully observing symptoms and how they change over time. The goal for the future is to diagnose the disease earlier, before movement symptoms appear.
The path to a clear diagnosis can take time, but you do not have to navigate it on your own. At Parkinson Pharos, we believe that knowledge builds confidence. Understanding the process, asking informed questions, and staying connected to reliable research can help you move forward with confidence and clarity.
If you are waiting for a diagnosis, or supporting someone who is, you are welcome to explore our personal stories and practical guides. We are here to support you.