Parkinsons (MoE)

Who to refer:

• Patients aged over 65 years old with suspected Parkinson’s Disease or a related movement disorder. Those under 65 years old should be referred via neurology Parkinson’s disease.
• The typical motor (movement) symptoms are: bradykinesia, rigidity, rest tremor and postural instability.
• Non-motor symptoms, which may also be present at diagnosis, include: constipation, loss of sense of smell, sleep disturbance, anxiety and low mood.
• Patients should be referred untreated.
• Parkinson’s Disease is a clinical diagnosis and for some patients establishing the diagnosis may take some time.
• Patients with other causes of parkinsonism or tremor are also seen in the movement disorder service:
  • Atypical Parkinsonism: Progressive Supranuclear Palsy (PSP), Multiple System Atrophy (MSA), Corticobasal Degeneration (CBD), Dementia with Lewy Bodies (DLB)
  • Vascular parkinsonism
  • Essential Tremor
  • Drug induced parkinsonism

Who not to refer:

• Patients who are unable to attend an outpatient clinic and engage in clinical assessment and examination.

How to refer:

• Patients aged over 65 years old with suspected Parkinson’s Disease should be referred via SCI Gateway to the appropriate local service:
• North Edinburgh: Western General Hospital – Geriatric Medicine (Dr Conor Maguire, Dr Gordon Duncan, Dr Liz Keane)
• South Edinburgh: Liberton Hospital – Geriatric Medicine (Dr Sarah Marrinan, Dr Joanne Renton)
• Midlothian: Liberton Hospital – Geriatric Medicine (Dr Sarah Marrinan, Dr Joanne Renton)
• East Lothian: East Lothian Community Hospital – Geriatric Medicine (Dr Lewis Morrison)
• West Lothian: St John’s Hospital – Geriatric Medicine (Dr Maria Corretge, Dr John Wilson)

MoE- Parkinson’s-SIGN guideline Diagnosis and pharmacological management of Parkinson’s

MoE-Parkinson’s disease BMJ download