Signs & Diagnosis of Parkinson’s Disease

Parkinson’s disease affects more than just movement. It can cause a range of physical, emotional and mental symptoms that often develop slowly. Understanding the early signs and how it’s diagnosed can help you or a loved one take the next step toward care and support.

At Banner Health, our neurology team includes movement disorder specialists with the experience to recognize Parkinson’s early and guide you forward. We listen closely, answer your questions and build a care plan that fits your life, not just your diagnosis.

What are the symptoms of Parkinson’s disease?

The signs of Parkinson’s vary for each person. Some affect how you move (motor symptoms), while others impact your mood, sleep, digestion and more (non-motor symptoms).

Both types of symptoms are important. You might notice just one or two symptoms at first. Over time, more may appear.

Motor symptoms 

These affect movement and usually start on one side of the body. They include:

• Tremors: Shaking in a hand, leg or the face, often while resting 
• Stiffness: Tight or hard-to-move muscles, especially in arms, legs or neck
• Slow movement (bradykinesia): Simple tasks, like getting dressed or brushing your teeth, may take longer
• Shuffling walk: Smaller steps, less arm swing, feet may feel stuck
• Posture changes: Stooped or hunched-over posture while walking
• Poor balance: Feeling unsteady or falling more often
• Small handwriting (micrographia): Writing becomes smaller and harder to read
• Soft or low voice: Speaking more quietly or sounding flat or monotone
• Masked facies: reduced facial expressions (appearing mask-like)

Non-motor symptoms 

Many people don’t realize that Parkinson’s can also affect parts of the body beyond movement. These non-motor symptoms can appear years before motor symptoms and may include:

• Loss of smell: Unable to smell certain foods or scents like you used to
• Constipation: Bowel movements are less frequent or harder to pass
• Increased bladder urgency: The feeling that you need to urinate immediately and uncontrollably
• Sleep problems: Tossing and turning, acting out dreams (REM sleep behavior disorder), feeling very tired during the day or restless leg syndrome
• Depression or anxiety: Increased tendency to feel sad, nervous or uninterested in things you once enjoyed
• Fatigue: Feeling very tired even when you haven’t done much
• Memory or thinking problems: Having trouble with multi-tasking, paying attention or remembering things
• Dizziness or fainting when standing: This can happen if your blood pressure drops when you stand up (orthostatic hypotension)
• Hallucinations or misperceptions: Seeing, hearing, feeling or smelling things that aren’t there

If you notice a few of these signs, it’s a good idea to talk with a provider. Explore treatment options that can help manage these symptoms.

When to see a provider for Parkinson’s symptoms

Not every tremor or muscle ache means you have Parkinson’s disease. But if symptoms don’t go away or begin affecting daily life, talk with your health care provider. They may refer you to a movement disorder specialist, a neurologist with advanced training in Parkinson’s and related disorders.

At Banner Health, our neurologists are experts in diagnosing and managing Parkinson’s. We take the time to listen to your concerns and support you in getting the care you need. 

Find a Banner Brain & Spine neurologist near you.

How doctors diagnose Parkinson’s disease

There is no single test for Parkinson’s disease. Diagnosis is based on your symptoms, medical history and a physical and neurological exam. In some cases, additional tests may help confirm the diagnosis or rule out other conditions.

Health care specialists now use updated criteria from the International Parkinson and Movement Disorder Society (MDS). These guidelines are based on the most current understanding of Parkinson’s and help neurologists make more accurate diagnoses, especially in the early stages of the disease.

Here’s how the process typically works:

Step 1: Medical history and symptom review

During your appointment, your neurologist will ask questions about:

• When your symptoms first started and how they’ve changed over time
• Any family history of Parkinson’s or other movement disorders
• Other health conditions and medications you’re taking

Step 2: Physical and neurological exam

Your doctor will check your movement, balance, coordination and reflexes. You may be asked to:

• Walk, turn, sit or stand
• Tap your fingers or show facial expressions
• Perform tasks to check for tremors, stiffness or slow movement

Step 3: Additional testing

While there’s no test that confirms Parkinson’s, there are tests that can support the diagnosis or rule out other conditions. Recent advancements in diagnostic tools and techniques help health care specialists make more accurate diagnoses earlier. 

Here are some tests commonly used:

• DaTscan imaging: A DaTscan uses a small amount of radioactive dye to show dopamine activity in the brain. It can’t confirm Parkinson’s but it can help when the diagnosis is uncertain or to distinguish Parkinson’s from similar conditions.
• MRI or CT Scan: Brain scans look at the brain’s structure, and can be useful to consider other conditions including stroke, normal pressure hydrocephalus or atypical parkinsonism. when symptoms are not classic for Parkinson’s.
• Genetic testing: In rare cases, Parkinson’s disease can run in families. A genetic test may be recommended to check for certain mutations (gene changes), especially in younger patients with a family history.
• Alpha-synuclein tests: These tests may detect abnormal clumps of protein called alpha-synuclein, which are linked to Parkinson’s disease. One test uses a lumbar puncture (spinal tap) to check cerebrospinal fluid, and another uses a small skin biopsy. These tests are available to help with diagnosis in special cases but are not used for everyone. 

Step 4: Medication response

Your provider may prescribe a trial of Parkinson’s medication, such as carbidopa-levodopa, to see if your symptoms improve. The medication helps raise dopamine levels in the brain. If your symptoms improve while taking it, this may support a Parkinson’s diagnosis.

Step 5: Ruling out other conditions

Many disorders can mimic Parkinson’s. Your provider will look for signs of:

• Essential tremor: a benign condition that causes shaking
• Medication side effects: Some drugs can cause Parkinson-like symptoms
• Other movement disorders: Like progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal syndrome (CBS), normal pressure hydrocephalus (NPH), or vascular parkinsonism

If you’re unsure about your diagnosis, consider getting a second opinion from a movement disorder specialist.

Early diagnosis leads to better outcomes. Learn about treatment options for Parkinson’s disease.

What to expect at a neurology appointment

Your first visit can feel overwhelming, but our team is here to support you.

Here’s what you can expect:

Before your visit:

• Write down your symptoms and when they started.
• Make a list of all medications, vitamins and supplements you take.
• Note any family history of Parkinson’s or similar symptoms.
• Bring a friend or family member if you can. They can help you remember details and ask questions.

During your visit:

• You’ll meet with a neurologist who will ask questions and examine your movement.
• You may be asked to walk, move your hands, speak or write.
• Additional tests or a follow-up visit may be recommended.

After your visit:

• If diagnosed, your neurologist will explain next steps.
• You’ll work together to create a treatment plan. This may include medications, therapy and lifestyle changes. 
• You’ll receive support and resources to help manage your condition. 

Concerned about Parkinson’s symptoms?

Schedule an appointment with the Banner Health movement disorders team today. Early diagnosis and expert care can help you stay active and independent longer.