Parkinsons Disease
Parkinson's disease is a condition in which parts of the brain become progressively damaged over many years. Symptoms of Parkinson's disease The main symptoms of Parkinson's disease are: involuntary shaking of particular parts of the body (tremor) slow movement stiff and inflexible muscles A person with Parkinson's disease can also experience a wide range of other physical and psychologic
What it is
Parkinson's is a progressive disorder of dopaminergic and non-dopaminergic systems. The classical motor features are bradykinesia plus rest tremor and/or rigidity. Non-motor features (REM sleep behaviour disorder, anosmia, constipation, depression) often pre-date the motor diagnosis by years. Differential includes essential tremor, drug-induced parkinsonism and atypical parkinsonian syndromes (PSP, MSA, CBD).
Symptoms and signs
- Slowness initiating movement, reduced facial expression, smaller handwriting (micrographia).
- Rest tremor — typically one-sided, pill-rolling, worse with stress.
- Stiffness or rigidity, often misdiagnosed as a frozen shoulder.
- Loss of arm swing, smaller step length, stooped posture, shuffling gait.
- Established PD with motor fluctuations, "off" periods, dyskinesia, sleep disturbance or behavioural change.
How we investigate
Detailed neurological examination and MRI brain to exclude structural mimics, arranged through our imaging partner Medneo. Where the diagnosis remains uncertain a DaTscan (123I-FP-CIT SPECT) may be recommended — this is a specialist nuclear-medicine investigation we do not provide, and your neurologist will refer you on to an appropriate centre. Cognitive screening, postural BP, sleep history. Genetic testing where there is a strong family history.
Treatment options at The Vesey
- Initiating therapy — levodopa-based therapy is the most effective; dopamine agonists or MAO-B inhibitors reasonable in selected younger patients.
- Optimisation review — dose-timing rebalancing, motor-fluctuation management, COMT inhibitor and amantadine where indicated.
- Advanced therapy referral — direct pathway to deep-brain stimulation, apomorphine infusion or LCIG centres.
- Non-motor symptom management — REM sleep behaviour disorder, constipation, urinary symptoms, postural hypotension, depression and impulse control disorders.
- Exercise prescription — high-intensity exercise has class-1 evidence for slowing progression; we coordinate with PD-specialist physiotherapy and dance / boxing programmes.
What is the difference between Parkinson's disease and essential tremor? +
Essential tremor is an action tremor — it is most noticeable when holding a cup or writing. Parkinson's tremor is a rest tremor — it occurs when the limb is relaxed and typically reduces during voluntary movement. Parkinson's also causes slowness and stiffness, which essential tremor does not.
How is Parkinson's disease diagnosed? +
Parkinson's is a clinical diagnosis based on the presence of bradykinesia plus rest tremor or rigidity. MRI brain is used to exclude structural causes. Where the diagnosis is uncertain a DaTscan can confirm dopamine transporter loss — particularly useful to distinguish from essential tremor or drug-induced parkinsonism. We do not provide DaTscans; your neurologist will refer you on to an appropriate centre if one is needed.
Can Parkinson's disease be treated? +
Yes. Current treatments are very effective at managing motor symptoms. Levodopa remains the most effective drug. Dopamine agonists, MAO-B inhibitors and COMT inhibitors are used alone or in combination. Advanced therapies (deep-brain stimulation, apomorphine, LCIG) are considered when medication alone is insufficient.
What is a wearing-off effect in Parkinson's disease? +
Wearing-off occurs when levodopa stops working before the next dose is due, causing a return of Parkinson's symptoms — stiffness, slowness, tremor — typically 3–4 hours after a tablet. It is a sign that levodopa is working but the dose interval needs adjustment. A neurologist can optimise the regimen to smooth out these fluctuations.
Pricing at a glance
Initial neurology consultation £260 (60 minutes). MRI brain from £325, arranged through our imaging partner Medneo. Cognitive testing included. Follow-up visits £190. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
When to see a specialist
Book if you have new symptoms suspicious for Parkinson's, established PD with motor fluctuations or wearing-off, you are weighing advanced therapy decisions, or you want a second opinion on diagnosis or treatment.
Cost and pathway
Initial neurology consultation £260 (60 minutes). MRI brain from £325, arranged through our imaging partner Medneo. Cognitive testing included. Follow-up optimisation visits £190.
- No weekend surcharge
- No GP referral required — book directly with our consultant neurology team
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.88/5 on Doctify from 700+ verified reviews
Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands
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