Specialist neurology · United Kingdom
Movement disorder treatment, by a sub-specialist neurologist.
Parkinson’s, essential tremor, dystonia, Huntington’s, tics, ataxia - a movement disorder consultant, a Parkinson’s nurse specialist, and access to the full MDT including neuropsychiatry, neurosurgery for DBS, and MRgFUS centres.
Why patients choose us
- 01
A movement disorder specialist, not a general neurologist
Parkinson’s, tremor, dystonia, Huntington’s, tics, ataxia - a sub-specialist consultant who sees these all week, not once a month.
- 02
The full MDT on the table
Consultant neurology, Parkinson’s nurse specialist, neuropsychiatry, physio, SLT, OT - and the neurosurgery team for DBS when it is right.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What movement disorder treatment costs privately in the UK.
Indicative ranges across our partner consultants and centres. NHS pathways are available for every step - DBS and MRgFUS are usually NHS-funded via specialist referral.
In short
A movement disorder consultation: £300–£500, usually within 1–2 weeks.
| Pathway | Indicative range | Typical duration | Frequency |
|---|---|---|---|
| Movement disorder consultation (new patient) | £300–£500 | 45–60 min | Same visit |
| Follow-up consultation | £200–£350 | 30 min | Same visit |
| Botulinum toxin injection (focal dystonia) | £450–£900 | 20–30 min | Every 3 months |
| Apomorphine SC infusion set-up | £2,500–£5,000 | Day-case | Ongoing |
| Duodopa (intestinal levodopa) initiation | £8,000–£15,000 | Inpatient | Ongoing |
| Deep brain stimulation (DBS) | £45,000–£75,000 | Inpatient 3–5 days | NHS-funded route usually |
| MRgFUS thalamotomy (essential tremor) | £25,000–£40,000 | Day-case | Some NHS commissioning |
Prices vary by consultant, centre and which advanced therapy is used. NHS-funded specialist pathways are available for every diagnosis, and DBS and MRgFUS are commissioned nationally for suitable patients. We confirm cover and firm pricing within one working day.
The problem
The right diagnosis, the right team, the right therapy.
Movement disorders are misdiagnosed more often than most neurological conditions. A sub-specialist and a proper MDT change the drug, the trajectory and the outlook.
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Is it Parkinson’s at all?
Essential tremor, vascular parkinsonism, drug-induced parkinsonism and functional disorders all mimic it. A DaTscan or the right examination changes the plan.
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Is the drug working?
Motor fluctuations, dyskinesia, impulse control problems, augmentation of RLS - a specialist review rebuilds the medication list.
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Is advanced therapy the answer?
Apomorphine, Duodopa, DBS and MRgFUS transform daily life for the right patient. The question is whether it is you - and when.
The journey
From enquiry to a written plan - what happens, in order.
One consultant leading the case, a Parkinson’s nurse specialist alongside, and the wider MDT looped in when it matters.
Phase 1 · Before your appointment
Concierge, off-stage for you
Phase 2 · At the clinic
Consultation, exam and plan
Phase 3 · After
Titration and MDT
- 01
Before
You tell us what is happening
A short, confidential form. Symptoms, when they started, current medication, any diagnosis so far, and what your GP or neurologist has said.
- 02
Before
We come back with a plan
Within one working day: which sub-specialist to see (Parkinson’s, tremor, dystonia, HD, tics, ataxia), what a first appointment should look like, and an indicative fee.
- 03
Before
We arrange the appointment
Usually within one to two weeks with a named consultant. Prior scans, GP letters and medication lists are gathered beforehand.
- 04
At the clinic
Consultation and examination
A structured movement examination - tremor, tone, gait, dystonia, tics - and a discussion of diagnosis, medication and non-drug options.
- 05
At the clinic
Tests where they add something
MRI brain, DaTscan (Parkinson’s vs essential tremor), genetics (HD, hereditary ataxia, dystonia) or neurophysiology - only when they change the plan.
- 06
At the clinic
A written management plan
A clear plan: which drug at what dose, non-drug therapies (physio, SLT, OT, CBIT), and whether advanced therapies (apomorphine, Duodopa, DBS, MRgFUS, botox) belong on the horizon.
- 07
After
Follow-up and titration
Medication is titrated over weeks, not days. A Parkinson’s nurse specialist or clinic team stays in touch, and review appointments track response and side effects.
Typical end-to-end: 1–2 weeks from enquiry to consultation. Medication titration: weeks to months.
When it helps
The movement disorders we see, and when to move.
The conditions we help with most, plus the one red flag that means a stroke pathway rather than a clinic booking.
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Parkinson’s disease
Tremor, stiffness, slowness, small handwriting, quiet voice - early diagnosis and the right first drug matter.
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Essential tremor
A tremor of the hands, head or voice that gets worse with action - often mistaken for Parkinson’s, treated very differently.
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Dystonia
Sustained muscle contractions - cervical, blepharospasm, laryngeal, writer’s cramp. Botox every three months is the mainstay.
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Huntington’s disease
A family history, chorea, mood or cognitive change - specialist HD team, genetics counselling, symptomatic drugs.
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Tics and Tourette’s
Motor and vocal tics from childhood or adolescence. CBIT first, medication for the rest, DBS for the severe refractory.
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Ataxia
Progressive imbalance, slurred speech, clumsy hands - hereditary, acquired or idiopathic. Ataxia-clinic pathway matters.
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Myoclonus, chorea, RLS, FMD
Sudden jerks, dance-like movements, restless legs, or functional movement disorder - each has its own pathway.
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Red flag: sudden onset
A sudden new tremor, weakness or difficulty walking is not a movement disorder to book - it is a same-day stroke pathway.
Treatment options
The therapies on the table, by diagnosis.
A summary of what each pathway actually involves - drugs, non-drug therapies, and the advanced therapies for the refractory.
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Parkinson’s - first-line drugs
Levodopa (Sinemet, Madopar), dopamine agonists (ropinirole, pramipexole, rotigotine patch), MAO-B inhibitors (rasagiline, selegiline, safinamide) - matched to age, symptoms and side-effect profile.
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Parkinson’s - advanced therapies
Apomorphine SC infusion, Duodopa intestinal levodopa, DBS (subthalamic nucleus or globus pallidus), MRgFUS thalamotomy for tremor-dominant.
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Essential tremor
Propranolol, primidone, topiramate or gabapentin first; botox for writing tremor; DBS-VIM or MRgFUS thalamotomy (NICE-endorsed) for the refractory.
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Dystonia - botox pathway
Botulinum toxin every three months into the offending muscles for cervical dystonia, blepharospasm, laryngeal or writer’s cramp - the mainstay of focal dystonia.
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Dystonia - generalised
Trihexyphenidyl, tetrabenazine and DBS-GPi for generalised or refractory dystonia; secondary dystonia treated by treating the underlying cause.
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Huntington’s disease
No disease-modifying therapy yet - symptomatic management with tetrabenazine, deutetrabenazine, olanzapine or sulpiride for chorea, plus HD team, genetics and psychiatry.
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Tics and Tourette’s
CBIT (Comprehensive Behavioural Intervention for Tics) first-line per NICE; aripiprazole, risperidone, clonidine, guanfacine or tetrabenazine; DBS for severe refractory adults.
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Ataxia, myoclonus, TD, RLS, FMD
Ataxia - supportive care via specialist clinics (Sheffield, London, Newcastle). Myoclonus - levetiracetam, valproate, clonazepam. Tardive dyskinesia - VMAT2 inhibitors. RLS - iron, rotigotine, gabapentin. FMD - neuropsychiatry MDT.
Our vetted UK network
A small panel of movement disorder consultants, we picked them.
Sub-specialists at Queen Square (UCLH) and the National Hospital for Neurology, plus regional centres in Sheffield, Manchester, Bristol, Edinburgh and Cardiff. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every consultant in our network.
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Movement disorder sub-specialists - not general neurologists
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Access to Parkinson’s nurse specialists (PNS) and specialist physio, SLT and OT
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Direct referral routes into DBS and MRgFUS centres (Queen Square UCLH, Sheffield, Manchester, Bristol, Edinburgh, Cardiff)
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Genetics counselling and neuropsychiatry for Huntington’s, hereditary ataxia and FMD
Safety and honest expectations
What to expect from treatment - honestly.
Movement disorder therapy is powerful, and the side effects are specific. The things worth planning are the diagnosis, the drug, and the red flags that mean an emergency.
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Diagnosis first, drugs second
Parkinson’s and essential tremor look alike but respond to completely different drugs. A sub-specialist examination - and sometimes a DaTscan - protects you from years on the wrong medication.
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Levodopa is still the gold standard
For symptomatic Parkinson’s, levodopa remains the most effective drug. Motor fluctuations are managed, not avoided by delaying it.
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Dopamine agonists - impulse control
Ropinirole, pramipexole and rotigotine can cause impulse control disorders - gambling, hypersexuality, compulsive shopping. Ask, and expect to be asked, at every review.
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Botox for dystonia is every 3 months
Focal dystonia is treated with repeat botulinum toxin every twelve weeks. The response builds - the first cycle is not always the best cycle.
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DBS is not a cure
Deep brain stimulation reduces tremor, rigidity and off-time - it does not stop the disease, does not usually help speech or balance, and needs an experienced MDT.
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MRgFUS is one-sided and irreversible
Focused ultrasound thalamotomy is quick, incisionless and NICE-endorsed for tremor - but it is a lesion, not a stimulator, and usually done on one side only.
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Huntington’s needs a specialist team
HD care is neurology, psychiatry, genetics, palliative and social work - not one clinician. Predictive genetic testing is done with proper counselling, never in a rush.
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Tardive dyskinesia - review the cause
Withdraw or switch the offending antipsychotic if possible (clozapine has the lowest risk); VMAT2 inhibitors are the specific treatment where available.
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Red flags
Sudden onset, high fever with rigidity (neuroleptic malignant syndrome or serotonin syndrome), or acute confusion on a new drug are same-day A&E, not clinic bookings.
Reading your clinic letter
Your clinic letter in four parts. Read the last one first.
Whichever movement disorder you have been seen for, the neurology letter keeps to the same shape.
A quiet reminder
Neurology language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the letter before your next review, just ask.
- 01 Header
Diagnosis and disease stage
Which movement disorder, at what stage - Parkinson’s Hoehn & Yahr, HD stage, dystonia distribution, tremor severity, tic severity (YGTSS).
- 02 Technique
Examination findings
Tremor (rest, postural, action), rigidity, bradykinesia, gait, dystonic postures, chorea, tics, cerebellar signs, cognitive screen.
- 03 Findings
Investigations
MRI brain, DaTscan (where used), genetics (HD, SCA, dystonia panels), neurophysiology, blood ferritin (RLS) - and whether they change the diagnosis.
- 04 Impression
Management plan and follow-up
Read this first: which drug at what dose, non-drug therapies, whether advanced therapy is on the horizon, and when the next review is booked.
Recognised by major UK insurers
Cover for movement disorder consultations, botox and advanced therapies varies by insurer and by diagnosis. NHS pathways are available for every step. We confirm cover before booking.
Frequently asked
Everything patients ask about movement disorder treatment.
Quick answers on Parkinson’s vs tremor, DBS, MRgFUS, Huntington’s, Tourette’s and restless legs.
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Is it Parkinson’s or essential tremor?
They look similar to a non-specialist but respond to completely different drugs. Parkinson’s tremor is usually at rest and asymmetric with slowness and stiffness; essential tremor is usually with action, often familial, and does not cause rigidity. A movement disorder specialist and, sometimes, a DaTscan settles the question.
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When should I start levodopa for Parkinson’s?
When symptoms interfere with daily life. Delaying levodopa to “save” it does not preserve future response - modern practice is to treat symptoms when they matter, using the lowest effective dose, and manage fluctuations as they arise.
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What is deep brain stimulation (DBS) and who is it for?
DBS involves implanting electrodes into the subthalamic nucleus or globus pallidus (Parkinson’s, dystonia) or the thalamic VIM (tremor). It reduces tremor, rigidity and off-time in carefully selected patients - usually people with a clear levodopa response, motor fluctuations, and no significant cognitive or psychiatric contraindication.
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What is MRgFUS and how does it compare with DBS?
MRI-guided focused ultrasound (MRgFUS) creates a small thalamic lesion without an incision to treat tremor. It is NICE-endorsed for essential tremor and tremor-dominant Parkinson’s. Compared with DBS it is quicker and incisionless, but it is a permanent lesion (not adjustable) and usually done on one side only.
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Is Huntington’s disease treatable?
There is no disease-modifying therapy yet - the tominersen antisense trial (GENERATION HD1) was halted in 2021 and further trials are ongoing. Symptomatic drugs (tetrabenazine, deutetrabenazine, olanzapine, sulpiride) help chorea, and a specialist HD team covers psychiatry, genetics, palliative and social care.
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How is dystonia treated?
Focal dystonia (cervical, blepharospasm, laryngeal, writer’s cramp) is treated with botulinum toxin injections every three months - the mainstay. Generalised or severe dystonia may need trihexyphenidyl, tetrabenazine or DBS of the globus pallidus. Secondary dystonia means treating the underlying cause.
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What is first-line for Tourette’s?
NICE recommends Comprehensive Behavioural Intervention for Tics (CBIT) as first-line. Medication - aripiprazole, risperidone, clonidine, guanfacine, tetrabenazine - is added when tics are disabling. DBS is reserved for severe refractory adults in specialist centres.
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How do you treat restless legs syndrome?
Check ferritin first - supplement iron if ferritin is under 75. Rotigotine patch, pramipexole or ropinirole are effective but risk augmentation with long-term use; gabapentin or pregabalin avoid this. Opioids are reserved for severe refractory cases.
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What does a private movement disorder consultation cost in the UK?
A new-patient consultation with a movement disorder specialist neurologist is usually £300–£500, follow-ups £200–£350. Botox for focal dystonia is £450–£900 per cycle. DBS is £45,000–£75,000 privately (NHS-funded via referral); MRgFUS is £25,000–£40,000 privately with some NHS commissioning.
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When should I call 999 rather than book a clinic?
Sudden new tremor, weakness, slurred speech or difficulty walking is a stroke pathway, not a movement disorder appointment. High fever with rigidity or confusion on a new drug (neuroleptic malignant or serotonin syndrome) is also a same-day emergency.
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