Parkinson’s Disease
A progressive condition of movement — but one where the right treatment, chosen at the right stage, can return years of independence.
Treatment
Neurological Evaluations
Every decision that follows depends on this one being right. A tremor named correctly is half of it treated.
Why the evaluation decides everything
A neurological evaluation establishes what the condition actually is, how far it has progressed, and which treatments the pattern supports. It is the step where the most consequential mistakes are avoided.
The distinction that matters most is between Parkinson’s disease and atypical parkinsonism — multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration. These can look similar in the first years and are frequently confused, but they do not respond to DBS in the same way. Operating on the wrong diagnosis helps no one.
The same applies to tremor: essential tremor, dystonic tremor, cerebellar tremor and drug-induced tremor each point to a different treatment.
What the evaluation includes
- Detailed history — onset, progression, family history, full medication list
- Neurological examination with standardised motor rating scales
- Levodopa response testing, where the diagnosis or surgical candidacy is in question
- High-resolution brain MRI; CT where MRgFUS is being considered, to measure skull density ratio
- Neuropsychological and mood assessment — required before DBS
- Blood tests to exclude metabolic and thyroid causes of tremor
- Speech, swallowing and gait assessment where relevant
The remote first step
For international patients the evaluation begins before travel and at no cost. We ask for neurologist reports, recent brain MRIs, a detailed medication list, and video of the motor symptoms recorded both “on” and “off” medication.
That is usually enough for the neurologists in our network to say whether a surgical option is plausible, which one, and what the on-site evaluation would need to confirm. We will not ask you to fly to Istanbul to be told you are not a candidate.
On arrival
Imaging and pre-operative tests are repeated here. This is not duplication for its own sake: stereotactic targeting requires high-resolution, protocol-specific scans acquired on the same equipment used to plan the procedure, and pre-operative clearances have to be current.
You leave with a written report — diagnosis, findings, recommendation and reasoning — in a form your neurologist at home can act on, whether or not you proceed with treatment here.
Conditions treated
Frequently asked questions
What do I need to send for the remote review?
Neurologist reports, recent brain MRI scans, a complete current medication list with doses and timings, and short videos of the symptoms — recorded both when medication is working and before the first dose of the day.
Why does the video matter so much?
Because a two-minute recording of walking before the first morning dose shows the team more than several pages of correspondence. Tremor, gait and rigidity are visible things.
Is the preliminary review really free?
Yes, and there is no obligation attached to it. If the assessment shows that a procedure would not help you, we will tell you so.
Not sure where to start?
Send us your reports and a short note. A coordinator replies within one working day — no cost, no obligation.