Skip to main content

Subspecialist neurology · London

Movement disorders clinic, by a subspecialist neurologist.

A private, MDT-backed clinic for Parkinson’s, essential tremor, dystonia, Huntington’s, tics and functional movement disorders. Named consultants at UCLH Private, King’s, HCA The Wellington, Cleveland Clinic London and Imperial Private.

A stethoscope on a clinical desk

Indicative pricing

What a private movement-disorders clinic costs in London.

In short

£350 to £550, follow-up £220 to £350.

Service Indicative range
Initial consultation (45 to 60 minutes) £350 to £550
Follow-up consultation £220 to £350
Botulinum toxin clinic (cervical dystonia, blepharospasm) £450 to £850
DaTSCAN (SPECT dopamine transporter imaging) £850 to £1,400
MRI brain with SWI protocol £500 to £900
Targeted genetics (GBA, LRRK2, HTT, ATXN panels) £350 to £900

Prices vary by consultant, by hospital and by whether investigations, botulinum toxin or genetics are included.

The journey

From referral to follow-up - what happens, in order.

One team from first message to structured follow-up, with a specialist nurse and MDT in the background.

  1. 04

    On the day

    Initial consultation, 45 to 60 minutes

    A full history, video-recorded neurological examination, MDS-UPDRS scoring where relevant, and a plan for imaging or genetics if diagnostic uncertainty remains.

  2. 05

    On the day

    Investigations, same visit or arranged

    MRI brain with SWI for iron, DaTSCAN for parkinsonism vs essential tremor, and targeted genetics (GBA, LRRK2, HTT, ATXN) when the phenotype suggests them.

  3. 06

    On the day

    Treatment plan and prescription

    Levodopa titration, MAO-B inhibitor, dopamine agonist or amantadine, botulinum toxin planning for dystonia, and onward referral for DBS or MRgFUS if indicated.

  4. 07

    After

    Follow-up and MDT

    A structured follow-up at 6 to 12 weeks, specialist-nurse contact between visits, and joint clinics with physiotherapy, SLT and neuropsychology when useful.

Conditions covered

The full range of hyperkinetic and hypokinetic disorders.

Also seen: drug-induced parkinsonism, restless legs syndrome, hemifacial spasm and paroxysmal dyskinesias.

  • Parkinson’s disease

    Rest tremor, bradykinesia, rigidity and postural instability. Levodopa response, non-motor symptoms and advanced-therapy planning.

  • Atypical parkinsonism (PSP, MSA, CBS)

    Early falls, vertical gaze palsy, autonomic failure or asymmetric apraxia flag atypical syndromes needing MRI and a careful re-review.

  • Essential tremor

    Action and postural tremor of the hands, head or voice. Propranolol, primidone or MRgFUS thalamotomy referral for medication-refractory cases.

  • Dystonia (cervical, blepharospasm, focal)

    Cervical dystonia, blepharospasm, hemifacial spasm, writer’s cramp and other task-specific focal dystonias. Botulinum toxin every 12 weeks.

  • Huntington’s disease

    Chorea, cognitive change and psychiatric symptoms with a family history. HTT genetic counselling and testing, with MDT support for family members.

  • Tics and Tourette syndrome

    Motor and vocal tics from childhood onwards. Habit reversal, comprehensive behavioural intervention and selective medication for disabling tics.

  • Myoclonus, chorea, ataxia

    Sudden jerks, dance-like movements or unsteadiness. A systematic search for structural, autoimmune, metabolic and genetic causes.

  • Functional movement disorders

    Functional tremor, gait or jerks with positive clinical signs. Explanation, physiotherapy and psychology in a non-stigmatising pathway.

Treatments offered

From levodopa to DBS - a full toolkit, chosen for you.

Medication, botulinum toxin, device-aided therapies (apomorphine, Duodopa) and surgical referral (DBS, MRgFUS), coordinated by the same neurologist and specialist nurse.

  • Levodopa optimisation

    Careful titration of co-careldopa or co-beneldopa, timing around meals, and management of wearing-off and dyskinesia with dose fractionation or controlled-release forms.

  • MAO-B inhibitors and agonists

    Rasagiline, selegiline or safinamide as adjuncts. Ropinirole, pramipexole or rotigotine patch for younger patients or as add-on, with impulse-control monitoring.

  • Amantadine for dyskinesia

    Amantadine immediate- or extended-release for troublesome peak-dose dyskinesia, weighed against cognitive and livedo side effects.

  • Apomorphine and Duodopa

    Subcutaneous apomorphine pen or pump, or levodopa-carbidopa intestinal gel via PEG-J, for advanced disease with motor fluctuations. Onward referral to a device-aided therapy centre.

  • Botulinum toxin injections

    EMG- or ultrasound-guided botulinum toxin for cervical dystonia, blepharospasm, hemifacial spasm, writer’s cramp and selected tremor syndromes, every 10 to 12 weeks.

  • DBS and MRgFUS referral

    Referral for deep brain stimulation (STN, GPi or Vim) or MR-guided focused ultrasound thalamotomy for medication-refractory tremor or Parkinson’s.

  • Physiotherapy and speech therapy

    Parkinson’s-specific physiotherapy (LSVT BIG, PD Warrior) and speech and language therapy (LSVT LOUD) for hypophonia, dysarthria and swallowing safety.

  • Second-opinion review

    A specialist review of your prior notes, imaging and video, sometimes reassurance, sometimes a change of diagnosis and treatment. £250 to £450.

What to know

Diagnosis, medication and monitoring - honestly.

Early diagnostic uncertainty is normal. Medication has trade-offs. A good clinic is honest about both and reviews you regularly.

  • Diagnostic uncertainty is common early

    Early Parkinson’s can look like essential tremor, vascular parkinsonism or drug-induced parkinsonism. A DaTSCAN separates presynaptic dopaminergic loss from mimics.

  • Drug-induced parkinsonism is often missed

    Metoclopramide, prochlorperazine, sodium valproate and antipsychotics can cause parkinsonism. A full medication review is part of the first visit.

  • Impulse-control disorders with agonists

    Dopamine agonists can trigger pathological gambling, hypersexuality, binge eating or compulsive shopping. Warned about, screened for, and dose-adjusted early.

  • Levodopa is not neurotoxic

    Delaying levodopa in the hope of preserving function is not supported by evidence. It is started when symptoms interfere with your work or life, not before, not later.

  • Botulinum toxin is not a permanent fix

    Botox lasts 10 to 12 weeks. Neck weakness, dysphagia or ptosis can occur in the first fortnight and settle. Repeat injections keep the effect going.

  • Red flags for atypical parkinsonism

    Falls in the first year, early autonomic failure, vertical gaze palsy or rapid cognitive decline should prompt a re-review, MRI and possible referral for atypical syndromes.

  • Genetic testing has real consequences

    Predictive HTT testing for Huntington’s is only offered with formal genetic counselling. GBA and LRRK2 results have implications for family members and future trials.

  • Driving and DVLA notification

    A diagnosis of Parkinson’s or a movement disorder that affects driving must be notified to the DVLA. DVLA guidance sets out what to declare and when.

  • Restless legs is treatable, not trivial

    Restless legs syndrome responds to iron replacement (ferritin target above 75), gabapentinoids or low-dose dopamine agonists. Augmentation with agonists needs vigilance.

Frequently asked

Everything patients commonly ask about movement-disorders clinics.

  • What is a movement-disorders clinic?

    A movement-disorders clinic is a subspecialist neurology service for people with hyperkinetic disorders (tremor, dystonia, chorea, tics, myoclonus) and hypokinetic disorders (Parkinson’s disease and atypical parkinsonism). The consultant has a dedicated fellowship-trained practice, uses video-recorded examinations and MDS-UPDRS scoring, and works with a wider MDT of specialist nurses, physiotherapy, speech and language therapy, neuropsychology and neurosurgery.

  • How much does a private movement-disorders consultation cost in London?

    An initial consultation with a subspecialist neurologist is typically £350 to £550 for 45 to 60 minutes. Follow-ups are £220 to £350. Botulinum toxin clinics for cervical dystonia or blepharospasm are £450 to £850 per session, including the toxin. DaTSCAN is £850 to £1,400 and MRI brain with SWI is £500 to £900.

  • Do I need a DaTSCAN to diagnose Parkinson’s?

    Not always. Parkinson’s disease is a clinical diagnosis. A DaTSCAN is helpful when there is genuine diagnostic uncertainty, for example separating early Parkinson’s from essential tremor, drug-induced parkinsonism or vascular parkinsonism. A normal DaTSCAN in a patient with a clinical picture that looked parkinsonian is called SWEDD and changes the diagnosis and treatment.

  • When should I consider deep brain stimulation or focused ultrasound?

    DBS is considered for Parkinson’s with motor fluctuations and dyskinesia despite optimised medication, and for medication-refractory essential tremor or dystonia. MR-guided focused ultrasound thalamotomy is an incisionless alternative for one-sided essential tremor or tremor-dominant Parkinson’s. Both need formal assessment by a specialist centre and are offered on the NHS as well as privately.

  • What is the difference between essential tremor and Parkinson’s tremor?

    Essential tremor is an action and postural tremor of the hands (often bilateral), head or voice, worse with movement, sometimes helped by a small amount of alcohol, and often familial. Parkinson’s tremor is a rest tremor, usually asymmetric, with bradykinesia and rigidity on the same side. A careful examination often distinguishes them; a DaTSCAN helps if it does not.

Related

Looking for something more specific?