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Special Article
January 1999

Diagnostic Criteria for Parkinson Disease

Author Affiliations

From the Department of Neurology, University of Michigan, Ann Arbor (Drs Gelb and Gilman); and the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md (Dr Oliver).

Arch Neurol. 1999;56(1):33-39. doi:10.1001/archneur.56.1.33

The clinical diagnosis of Parkinson disease (PD) is based on the identification of some combination of the cardinal motor signs of bradykinesia, rigidity, tremor, and postural instability, but few attempts have been made to develop explicit diagnostic criteria. We propose a clinical diagnostic classification based on a comprehensive review of the literature regarding the sensitivity and specificity of the characteristic clinical features of PD. Three levels of diagnostic confidence are differentiated: Definite, Probable, and Possible. The diagnoses of Possible and Probable PD are based on clinical criteria alone. Neuropathologic confirmation is required for the diagnosis of Definite PD in patients with the clinical diagnosis of Possible or Probable PD. Criteria for histopathologic confirmation of PD are also presented.

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