Northwestern's Comprehensive Care Model - Neurologist Consultation

When a patient comes to our clinic, our Clinical Nurse and our Movement Disorders Neurologist are the first professionals who see the patient. They gather a complete Medical History, which includes:

  • symptoms
  • past and current medications, dosages. and side effects
  • physical conditions
  • family history
  • social history
  • medical records related to current problem
  • recent MRIs or CAT scans of brain or spine, along with any accompanying written reports
  • names and contact information of physicians currently involved in patient's care

Because the diagnosis of Parkinson's disease and other movement disorders is a clinical judgment, based on the observations of a skilled specialist, the neurologist performs a thorough physical examination and spends as much time as necessary talking with the patient and family about their concerns and questions. We encourage a care partner or other family member or friend to accompany the patient to the neurology clinic, since another person may notice changes or symptoms of which the patient is unaware.

Since no definitive diagnostic test can confirm the presence or absence of Parkinson's disease and Atypical Parkinson Syndromes, the neurologist might order Magnetic Resonance Imaging (MRI) of the brain in order to rule out other potential causes for the patient's symptoms. MRI does not detect dopamine deficiency itself. Therefore, some patients under 50 years of age, and who have symptoms similar to PD, may also be screened for Wilson's disease.

The physician will likely need to observe the patient over several months until it becomes clear that symptoms are consistent over time and are congruent with a presumed diagnosis.

The movement disorders specialist uses a standardized assessment tool known as the Unified Parkinson Disease Rating Scale (UPDRS) to help diagnose Parkinson's disease and to follow a patient's progress over time. The survey evaluates motor function, patient's subjective experience of symptoms, performance of activities of daily living (ADLs), and side effects of medications.

During their time with the patient and family, the Clinical Nurse and Neurologist will learn about the patient's quality of life, relationships, day-to-day functioning, exercise habits, and the like. Once the Medical Consultation is complete, the patient will then have an opportunity to talk with, and receive assessments or recommendations from, the allied health professionals on the multidisciplinary team.

Comprehensive Care Model