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, MRI brain to exclude structural mimics, DAT scan (123I-FP-CIT SPECT) via partner imaging where the diagnosis is uncertain. 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. A DAT scan (DaTSCAN) can confirm dopamine transporter loss when the diagnosis is uncertain — particularly useful to distinguish from essential tremor or drug-induced parkinsonism.
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 £450. DAT scan from £950 (via partner). Cognitive testing included. Follow-up visits £190. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
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 £450. DAT scan from £950 (via partner). Cognitive testing included. Follow-up optimisation visits £190.
- Open 7 days including Sundays — 8am to 8pm, 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 · Open 7 days 8am–8pm
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