The movement disorder team are involved in treating conditions where abnormal involuntary movements are the main problem. These include the following:
- Parkinson’s disease – a condition where tremor, stiffness and slowness of movement, as well as many non-movement symptoms, occur. Around 120,000 people in the UK suffer from Parkinson’s.
- Atypical parkinsonism – conditions such as multiple system atrophy and progressive supranuclear palsy which may mimic Parkinson’s disease but are typically more rapidly progressive and difficult to treat.
- Dystonia – a condition where abnormal movements and postures of the neck and other body parts occur. Many people with focal dystonia receive effective treatment with botulinum toxin injections to the affected area.
- Tremor – involuntary shaking, often of the hands but also head and other body parts.
- Tic disorders – movements preceded by an urge to move/speak such as Tourette syndrome.
Conditions such as Parkinson’s can be effectively treated with medication to replace the chemical dopamine in the brain, but we know that many other symptoms other than abnormal movements occur in Parkinson’s and it is important to identify and treat these. People with complex progressive conditions such as Parkinson’s benefit from access to specialist care as well as Parkinson’s disease Nurse Specialists, who provide a point of contact, information and support as well as follow-up. As Parkinson’s progresses, fluctuations in the response to medication occur. We offer the full range of treatments for this stage of the disease: infusion therapies with apomorphine and levodopa-carbidopa intestinal gel, and deep brain stimulation surgery. We hold a monthly multidisciplinary team (MDT) meeting where these treatments are discussed to make sure people get the treatment that is right for them.
Our team are dedicated to improving the care and experience of people with movement disorders. Recent initiatives have included improving timely delivery of medication to people with Parkinson’s on the ward, improved protocols for looking after acutely confused patients, and improving fracture risk assessment in Parkinson’s. We work closely with colleagues in Ageing and Complex Medicine to ensure that inpatients with Parkinson’s and related conditions are well cared for and assessed. We run a regional clinic for atypical parkinsonism, one of only a few in the UK and have a great deal of experience in managing these challenging conditions. We offer specialist clinics for the complex non-motor and cognitive problems that develop in Parkinson’s, and have strong links with neuropsychology colleagues who are able to assess and support patients with specific cognitive and behavioural problems.
The movement disorder team are very active in the field of research into these conditions. Dr Silverdale and Dr Kobylecki are leading several research studies and clinical trials in movement disorders, including studies of pain in Parkinson’s, and new ways to identify muscle activation in cervical dystonia. Our research has been published in international peer-reviewed journals and presented at national and international medical conferences. We have several clinical and non-clinical research fellows working with us on our research studies.
We have a strong track record of teaching and training in movement disorders. We regularly hold regional educational meetings on different aspects of movement disorders, as well as being involved in training neurologists from across the North West in this discipline.
Dr Monty Silverdale, Consultant Neurologist
Dr Christopher Kobylecki, Consultant Neurologist
Dr Jeremy Dick, Consultant Neurologist
Dr Hilary Tyne, Consultant Neurologist
Dr Mark Kellett, Consultant Neurologist
Dr Fernando Garcia del Carrizo, Consultant Neurologist
Patsy Cotton, Advanced Nurse Practitioner in Movement Disorders
Carol Miller, Parkinson’s Disease Nurse Specialist
Lucy Partington-Smith, Movement Disorder and Deep Brain Stimulation Specialist Nurse
Diane Ashton, Dystonia Nurse Specialist
Dr Richard Hackett, Consultant Neuropsychiatrist