The most common movement disorder is Parkinson’s disease. However, any disease that affects the movement of the body may fall into the category of ‘Movement Disorder’ and require treatment by a neurologist and/or neurosurgeon. 

Our patients with Parkinson’s disease and other movement disorders receive medical and surgical management of their conditions through a multidisciplinary approach involving neurology, neurosurgery and physical/occupational therapy.

Parkinson’s Disease
Parkinson’s disease is a chronic, progressive degenerative disorder resulting in difficulty with voluntary movement. Parkinson’s disease most likely represents several disorders where areas in the brain produce less dopamine, a neurotransmitter essential to motor movement. 

Symptoms
The most common symptoms of Parkinson’s disease are rigidity, tremor, posture instability  and slowness of movement. Initial symptoms of Parkinson’s disease often include smaller steps taken when walking, change in swallowing ability and decreased arm swing when walking. While Parkinson’s disease is most commonly associated with movement symptoms, patients may exhibit neuropsychiatric symptoms as well. Patients with Parkinson’s disease may have increased memory loss, obsessions or depression. Dementia is commonly associated with Parkinson’s as the disease progresses. 

Risk Factors

• Family history of Parkinson’s disease
• Exposure to pesticides

Treatment

• Medical Management - Early recognition of Parkinson’s disease is important to slow the disease progression.  Parkinson’s disease is generally managed with a combination of medications.  A multidisciplinary team including physical therapists, occupational therapists and speech therapists help to support the patient and family and manage any side effects from the disease.  

• Surgical Management - Patients with Parkinson’s disease may benefit from a Deep Brain Stimulation (DBS) therapy. DBS involves implanting one or two electrodes into the brain, targeting the regions of the brain which are overactive in Parkinson’s disease.  A small generator is implanted under the skin, and through stimulation of the brain electrodes, significant improvement in function can be achieved.  For the properly selected patient, DBS has been proven to be more effective than medication management alone in refractory Parkinson’s disease.
  

Other Movement Disorders

Essential Tremor
Essential tremor is another condition which can lead to disabling tremor when a patient moves their arms.  The tremor is usually absent when the arms are resting, and the tremor increases when the patient moves his/her arms.  Symptoms are usually present from early adulthood and progress with time.  Some medicines can provide relief of the tremor.  However, many patients can benefit from DBS.  This therapy involves the implantation of an electrode into the brain on the side opposite from the tremor.  If tremor is present on both sides, electrodes can be implanted on both sides of the brain.  The electrodes are connected to a small implanted generator, and through stimulating the brain electrodes, significant relief of the tremor can be achieved.