Movement Disorders & Parkinson's Centre

The Movement Disorders & Parkinson's Centre at SilverOak Health provides dedicated, multidisciplinary care for patients with Parkinson's disease, essential tremor, dystonia, Huntington's disease, ataxias, and other movement disorders. Our movement disorder neurologists, specialist Parkinson's nurses, physiotherapists, occupational therapists, and speech-language pathologists work within an integrated team to optimise every aspect of function, independence, and quality of life for our patients.

Diagnosis of movement disorders is grounded in detailed clinical assessment, supplemented by DaTSCAN functional neuroimaging to confirm dopaminergic deficit, MRI brain with specific movement disorder protocols, neuropsychological evaluation, and — when relevant — genetic testing for familial Parkinson's disease, dystonia genes, or Huntington's. Accurate diagnosis is critical because treatment strategies differ significantly between parkinsonian syndromes, tremor disorders, and atypical parkinsonism such as MSA and PSP.

Medical management of Parkinson's disease employs the full range of dopaminergic therapies — levodopa, dopamine agonists, MAO-B inhibitors, and COMT inhibitors — optimised to minimise motor fluctuations and dyskinesias while maximising on-time. For advanced Parkinson's disease with refractory motor fluctuations, we offer device-aided therapies including subcutaneous apomorphine infusion, duodenal levodopa-carbidopa intestinal gel (Duodopa), and deep brain stimulation surgery.

Deep brain stimulation at our centre is performed with the patient awake under local anaesthesia, enabling real-time neurological assessment during microelectrode recording and lead placement to optimise targeting accuracy within the subthalamic nucleus, globus pallidus internus, or thalamus. Post-implantation programming by our specialist DBS neurologist optimises stimulation parameters at one, three, and six months, with annual reviews thereafter. Rechargeable implantable pulse generators with battery lives up to 25 years reduce the frequency of battery replacement procedures.

A comprehensive allied health programme — addressing gait and balance rehabilitation, falls prevention, LSVT BIG physiotherapy, LSVT LOUD speech therapy, and occupational therapy for fine motor and activities of daily living — is provided through individual and group formats. Neuropsychiatric aspects of movement disorders including depression, anxiety, impulse control disorders, and cognitive decline are managed within our programme with input from liaison psychiatry and clinical neuropsychology. Our annual movement disorders symposium brings patients, carers, and clinicians together to share advances in care and research.