Iveta Idzelytė1, Iveta Lasickaitė1
1Lithuanian University of Health Sciences, Faculty of Medicine
Parkinson’s disease is a neurodegenerative disorder that mainly affects the motor system. It is age-related and is one of the more common chronic neurological diseases of the elderly. Symptoms start gradually and as the disease progresses a person’s daily activities are significantly disrupted. One of the first symptoms the patient complains about can be a barely noticeable tremor in just one hand which usually occurs at rest. In the typical course of the disease, in addition to tremor, bradykinesia, muscle rigidity, and postural instability are also found. There may be additional criteria to confirm the diagnosis, such as a good response to levodopa treatment, but it is important to keep in mind the differential diagnosis and lookout for signs of another disease with similar symptoms that may require different methods of treatment. Although the diagnosis of Parkinson’s disease is usually based solely on clinical signs and symptoms, there may be some unclear cases where the course or combinations of symptoms are atypical. In such cases, another possible diagnosis should be taken into consideration, for example, essential tremor, progressive supranuclear palsy, Lewy body dementia or secondary Parkinsonism caused by medication, intoxication, head trauma and so on. If a physician is unable to confirm the diagnosis of Parkinson’s disease a DaTscan examination may be performed – SPECT (single-photon emission computed tomography) scan with radiopharmaceutical drug 123I – ioflupane. Although this type of examination is expensive and the patient is exposed to ionizing radiation, various scientific studies have shown that the sensitivity and specificity of DaTscan are high in the diagnosis of Parkinson’s disease and is therefore recommended in cases where the diagnosis is inconclusive, a patient has tremor of uncertain origin, or non-motor symptoms associated with Parkinson’s disease are present but the motor symptoms are atypical.
Keywords: Parkinson‘s disease, DaTscan