Dr Vernon Parfitt - Diabetes & Endocrinology

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GMC Number: 2806909

Year of first qualification: 1983, University of Bristol

Specialty: Diabetes & Endocrinology

Clinical interest: Endocrinology and diabetes mellitus, General medicine (dual

accredited)

Secretary: Yvette Wardle

Telephone: 0117 414 6419

Dr Vernon Parfitt, MbChB, MD, FRCP,  is a senior Consultant physician in endocrinology and diabetes and general medicine. He qualified from Bristol University Medical School in 1983. He has trained in Bristol, South Wales, London, Southampton and Bath.
He practices in general diabetes and endocrinology and general medicine.
Special interests include Insulin pump therapy, diabetes technology, type 1 diabetes, pituitary disease, hypertension, thyroid and parathyroid disease.

Parfitt

Movement Disorders Service Useful Links

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Idiopathic Parkinson’s disease
The most common symptoms of Idiopathic Parkinson’s disease (IPD) are tremor, stiffness and slowness of movement. It results from a loss of nerve cells in the brain that produce a chemical called dopamine. The cause of Parkinson’s disease is not fully understood. Currently, it's believed a combination of genetic changes and environmental factors may be responsible for the condition. The symptoms of Parkinson’s disease can vary greatly between individuals. Although there is no cure for Parkinson’s disease, there are a wide variety of medications and therapies that can be used to help with the symptoms.
www.parkinsons.org.uk
www.cureparkinsons.org.uk

Multiple System Atrophy
Multiple system atrophy (MSA) is a progressive neurological disease that causes nerve cells to shrink in different areas of the brain. This results in problems with movement, speech, balance and often difficulties with bladder function and blood pressure control. It can be a difficult condition to diagnose especially in the early stages. There is no cure for MSA but the best treatment usually involves a combination of medication and specialised input from therapists to manage different symptoms.
www.msatrust.org.uk

Progressive Supranuclear Palsy
Progressive supranuclear palsy (PSP) is a disease that occurs when brain cells in certain parts of the brain are damaged as a result of a build-up of a protein called tau. The condition leads to symptoms including loss of balance, slowing of movement, difficulty moving the eyes, and problems with speech and swallow. PSP may be mistaken for other neurodegenerative diseases such as Parkinson’s disease. The cause of the condition is uncertain. There is no cure for PSP but patients can benefit from having medications to manage different symptoms as well as input from therapists which can help improve their quality of life.
www.pspassociation.org.uk

Corticobasal syndrome
Coticobasal syndrome (CBS) is caused by the abnormal accumulation of the protein tau in certain nerve cells in the brain. People affected by CBS may present with cognitive, movement or language symptoms as the first sign. It can be difficult to diagnose, especially in the early stages. Individuals with CBS are easier to diagnose if they are showing limb apraxia, such as no longer being able to use the remote control for the television set, or not being able to retrieve mail from the mailbox. Initial symptoms of CBS often begin around age 60. Patients are sometimes tried on medications used to treat Parkinson’s disease but these are usually not effective. Patients may benefit from occupational therapy, physiotherapy and speech therapy.
www.pspassociation.org.uk

Essential  Tremor
Essential tremor (ET) is the most common neurologic movement disorder, and is 8–10 times more prevalent than Parkinson's disease. In some people, the tremor may be relatively non-progressive and may be mild throughout their life. In other people it may slowly progress over the years and can impair their ability to do certain tasks. It typically affects the hands and arms, though sometimes may also involve the head, voice, trunk and legs. Treatments available include medications and in more severe cases surgery may be an option.
https://tremor.org.uk

Dystonia
In dystonia, faulty signals from the brain cause muscles to spasm and pull on the body incorrectly. This forces the body into twisting, repetitive movements or abnormal postures. Sometimes the symptoms are accompanied by dystonic tremor. Various treatments are available for dystonia, depending on the type and severity a person has. The main options are drugs, physiotherapy, botulinum toxin and surgery.
www.dystonia.org.uk

Tic Disorders
Tic disorders often start in childhood with abrupt involuntary movements and uncontrollable sounds. Many patients will experience co-occurring conditions which might include Attention Deficit Hyperactivity Disorder (ADHD), Obsessive Compulsive Disorder (OCD), and Anxiety.  Tics often seem to run in families, and there is likely to be a genetic component in many cases. If tics are mild they may not need treatment but some patients can benefit from medications or behavioural therapies.
www.tourettes-action.org.uk/

Functional movement disorders
Functional Movement Disorders (FMD) are among the most common reasons for patients to present to a movement disorder specialist. Symptoms include tremor, dystonia, chorea, jerky movements and walking problems. The brain of a patient with functional neurological symptom disorder is structurally normal, but functions incorrectly. Patients with FMD can benefit from graded exercise/physiotherapy, cognitive behavioural therapy  and medication to help pain and sleep.
www.neurosymptoms.org
https://fndhope.org/

Restless Leg Syndrome
Restless legs syndrome (RLS) is a disorder that causes an unpleasant or uncomfortable sensation in the legs resulting in a strong urge to move them. This is often described as aching, tingling, or crawling in the legs. Occasionally the arms may also be affected. The feelings generally happen when at rest and therefore can make it hard to sleep. Due to the disturbance in sleep, people with RLS may have daytime sleepiness, low energy, irritability, and a depressed mood. It can often improve with medication.

Movement Disorders Service Team

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Consultant Neurologists

Dr Alan Whone  
Secretary: Laura Martin   
Telephone: 0117 414 6690

Dr Konrad Szewczyk-Krolikowski  
Secretary: Laura Martin
Telephone: 0117 414 6690

Dr Mihaela Boca  
Secretary: Tracy Chiddy
Telephone: 0117 414 7984

Dr Sabine Klepsch 
Secretary: Tracey Gore   
Telephone: 0117 414 6692

Care of the Elderly Physicians with an interest in Parkinson’s

Dr Jarrod Richards   

Medicine for Older People Specialty Lead

Dr Edward Richfield  
Telephone: 0117 4146445

Movement Disorder Nurse Specialists

The Movement Disorder Nurse Specialists work in the complex therapies service and provide an in-reach service for patients on the wards who have a diagnosis of Parkinson’s.

Lucy Mooney  
Lead Movement Disorder Nurse Specialist

Caroline Robbins  

Caroline Norris    

Jeanette Brooks 

Cissy Thomas  

Sophie Chilcott

Complex Therapies Nurse Telephone Clinic

Telephone 0117 414 8269 

Mondays to Fridays, 09:00 – 17:00 hours

In Emergency Situations only

Please ring Movement Disorder Nurse Specialist on 07874885155 (This mobile number has replaced the different bleeps)

Complex Therapies Administration Team

Susan Aiers  

Sarah Adair  

Telephone: 0117 4148266

Telephone: 0117 414 8279

movdiscomplextherapiesadmin@nbt.nhs.uk 

AbbVie Duodopa® 24-hour helpline:  0800 4584410

Britannia APO-go® (Apomorphine) Technical Helpline:   0844 880 1327

DBS Surgical Team

Consultant Neurosurgeons

Mr Neil Barua    

Ms Reiko Ashida  

DBS Surgery Co-ordinator

Safina Saddique  

Telephone: 0117 4146700

Mr Iain Packham - Trauma & Orthopaedics

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GMC Number: 4335676

Year of first qualification: 1996, Nottingham

Specialty: Trauma & Orthopaedics

Clinical interest: Shoulder and elbow

Secretary: Sue Griffin

Telephone: 0117 414 1622

Mr Iain Packham undertook surgical training in London before Fellowships at the Cape Shoulder Institute and the Australian Institute of Musculoskeletal Surgery. 

His specialist interest is in the treatment of sports injuries, arthritis and fractures around the shoulder with a focus on key-hole surgery.

He has a particular interest in patient safety and is a Clinical Risk Committee Musculoskeletal representative.

Packham

Movement Disorders Service

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Movement Disorders ServiceWe have a dedicated multidisciplinary team with expertise in the management of Parkinson’s disease and other movement disorders. We provide diagnosis, assessment and treatment for a full range of movement disorders, including but not limited to:

  • Parkinson's disease and atypical parkinsonism.
  • Functional Movement Disorders.
  • Dystonia.
  • Chorea.
  • Tremor.
  • Myoclonus.
  • Tics and Tourette syndrome.
  • Restless legs syndrome.
  • Gait disorders.

We are a major UK center for providing advanced therapies (including deep brain stimulation surgery) for movement disorders, particularly Parkinson’s disease, dystonia and essential tremor.

Our team includes neurologists, neurosurgeons and clinical nurse specialists. We offer a number of specialist clinics and services including Apomorphine therapy, Duodopa therapy, specialised neurophysiology and botulinum toxin injections. The group also makes a significant contribution to research in movement disorders and has been successfully involved in a number of innovative trials.

Download patient information leaflets:[attachments]

Movement Disorders Service

Dr Jon Oxley - Cellular Pathology

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GMC Number: 4013853

Year of first qualification: 1993, London

Specialty: Histopathology

Clinical interest: Uropathology and dermatopathology

Secretary: Catherine Neale

Telephone: 0117 414 9890

Fellow of the Royal College of Pathologists, member of British Association of Uropathologists, International Society of Uropathologists.

Oxley

Dr Agyepong Oware - Neurophysiology

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GMC Number: 3448379

year of first qualification: 1982, University of Ghana

Specialty: Neurophysiology

Clinical interest: Disorders of Peripheral Nerves and muscle 

Secretary: Shirley Lear

Telephone: 0117 414 1050

Dr Agyepong Oware trained in Neurology at the Jacobi & Montefiore Hospitals, New York and Clinical Neurophysiology at The National Hospital, Queen Square and Great Ormond Street Children's Hospital.
Dr Oware is a member of the following Professional bodies - Royal College of Physicians, London (Fellow), British Society of Clinical Neurophysiology, British Peripheral Nerve Society, American Academy of Neurology and American Association of Electrodiagnostic Medicine

Oware

Mr Antonio Orlando - Plastic Surgery

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GMC Number: 4083711

Year of first qualification: 1988, University of Florence, Italy

Specialty: Plastic Surgery

Clinical interest: Melanoma, Skin Cancer, Head and Neck Surgery

Secretary: Joanne Hawkins

Telephone: 0117 414 7607

Mr Antonio Orlando is the Chair of the Specialist Skin Cancer MDT at North Bristol NHS Trust.

He is the Lead Clinician in Skin Cancer and in Head and Neck Surgery for Plastic Surgery.

His other interests  include Facial Palsy, Electrochemotherapy. 

Mr Orlando is a member of the Editorial Board of JPRAS. 

Orlando