Parkinson’s Disease is a clinical diagnosis with the essential feature being bradykinesia, plus one of these:

• rest tremor,
• increased tone or
• postural instability

It tends to be initially unilateral, then can be bilateral, but asymmetrical.

Please don’t start treatment before the patient is seen, this can make diagnosis even more challenging.

It is a progressive condition which is not sudden in onset.

Patients with symptoms suggestive of Parkinson's disease.

Other forms of Parkinsonism:

• Vascular
• Drug-induced
• Parkinson's plus syndromes
  • Multiple System Atrophy
  • Progressive Supra Nuclear Palsy
  • Cortico-Basal Degeneration
  • Lewy Body Dementia (shared with mental health)
• Essential tremor where diagnosis is in doubt

Refer routinely via SCI-Gateway...Geriatric Medicine

It is a progressive condition which is not sudden in onset, therefore urgent referrals are unusual, unless a patient has presented very late and is struggling to mobilise. All patients wish to be seen as soon as possible and we endeavour to do so.

Patients with Restless Legs Syndrome 

Patients with essential tremor where the diagnosis is clear but if not sure then referral for single assessment appointment is reasonable.

Referrals of any age, via SCI Gateway to the Movement Disorder Service (under the care of the elderly directorate) – will be seen by either Dr Shona Donaldson (Associate Specialist Doctor in Care of the Elderly) or Dr Mignon Gerrits (Consultant in Neurology).

Our PD nurse specialists are Shona Graham and Laura Chapman who job share and are contactable directly by patients known to the service, for advice on their PD management. For non-PD queries the patients will be redirected to their primary care providers.

They are available for direct support for referrers on 01387 241909. Their email addresses are shona.graham3@nhs.scot or laura.chapman36@nhs.scot. They don’t see new referrals, these will be seen by medical staff in the first instance.

Our secretary can help with appointment advice. Angela Haining is available on 01387241349 or email to dg.care-of-the-elderly-rehab@nhs.scot.