Aktuelle Diagnostik und Differenzialdiagnostik beim Morbus Parkinson

Zusammenfassung

Die Diagnose des Morbus Parkinson erfolgt nach klinischen Kriterien. In differenzialdiagnostisch schwierigen Fällen können die kranielle Kernspintomografie und nuklearmedizinische Untersuchungen wichtige Zusatzinformationen liefern, mit denen die Abgrenzung des Morbus Parkinson gegenüber atypischen und sekundären Parkinsonsyndromen unterstützt werden kann. Da zum Zeitpunkt der klinischen Diagnosestellung bereits eine weitgehende Degeneration nigraler Neuronen vorliegt, wird in Zukunft der Frühdiagnostik des Morbus Parkinson eine bedeutende Rolle zukommen. Hier werden verschiedene Verfahren wie der Riechtest, die Farbdiskrimination, die motorische Leistungsserie und der transkranielle Ultraschall diskutiert, wobei deren Sensitivität und Spezifität derzeit unklar ist.

Summary

Idiopathic ParkinsonŽs disease (PD) is diagnosed following clinical criteria. Cranial nuclear magnetic resonance imaging and nuclear medicine studies may help in cases with a difficult differential diagnosis of PD versus atypical and secondary parkinsonian syndromes. The earlier diagnosis of PD will become increasingly important since nigral degeneration has proceeded substantially at the time of clinical diagnosis. Different tools such as olfactory testing, color discrimination, motor performance test battery and transcranial ultrasound might allow an earlier diagnosis of PD, but sensitivity and specificity of these methods are not clear yet.

Key Words

Parkinson's disease - atypical parkinsonian syndromes - nuclear medicine diagnostics - nuclear magnetic resonance imaging

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