What criteria should I use to determine when to refer a patient with suspected Parkinson's Disease to a specialist?

Refer all people with suspected Parkinson's disease urgently, and untreated, to a specialist with appropriate expertise in movement disorders, such as a neurologist or elderly care physician, to confirm the diagnosis and exclude alternative diagnoses ¹.

Refer adults with suspected parkinsonian tremor, other asymmetric tremor, or tremor associated with stiffness, slowness, balance problems or gait disorders for neurological assessment before treatment ⁴.

Refer adults with suspected Parkinson's disease if they present with tremor, stiffness, slowness, balance problems, or gait disorders, to ensure accurate diagnosis and management ².

Arrange urgent specialist referral before starting drug treatment, as drug treatment can mask signs needed for diagnosis, and early specialist assessment helps prevent misdiagnosis ¹.

Refer if there are atypical features or if the clinical presentation suggests alternative diagnoses such as atypical parkinsonism or other neurological conditions ¹.