Movement Disorders
Movement disorders cause abnormal physical responses such as tremors, lack of coordination, muscle tightness, difficulty walking, and other uncontrolled movement. While these conditions don’t usually affect thinking or memory, they do create physical, social, and emotional challenges.
If you or a family member is living with Parkinson’s disease, essential tremor, or a dystonia, the specialists at Premier Health can help.
Our neuroscience care teams, including neurologists, neurosurgeons, neurology nurse specialists, dedicated neuroscience social workers, and occupational and physical therapists work with you to create a treatment plan that improves your quality of life and minimizes the effects of your condition.
Types of Movement Disorders
There are different kinds of movement disorders. The most common conditions include:
Essential tremor. Familial or essential tremor affects as many as 40 percent of adults older than 40 to some degree. The condition becomes more common with age and often is inherited.
Symptoms of essential tremor include:
- Mild to severe shaking when using the affected body part, such as holding a fork to eat or a glass to drink.
- Reduced movement and dexterity, such as when buttoning clothes or signing a check.
Essential tremor can be very disabling and embarrassing. In some people the tremor gets worse over time.
Parkinson’s disease. Parkinson’s disease involves brain cells that help organize your body’s movement. These cells make a chemical called dopamine that assists in the proper function of many other areas of your brain. As these brain cells are lost in Parkinson’s disease, the amount of dopamine your body makes decreases. Without enough dopamine, other centers of your brain no longer work properly, leading to difficulty in many important functions.
Symptoms may include:
- Constipation and weight loss
- Difficulty with speaking and swallowing
- Poor balance and falls
- Slowness in movement
- Stiffness
- Resting tremor
- Fluctuating blood pressure
- Loss of facial expression
Dementia can occur in some patients, but is not a common feature of Parkinson’s disease.
Dystonia causes involuntary muscle contractions as a result of related problems in the brain. These movements cause the muscles of arms, legs, head and neck, and/or face to maintain abnormal and undesired postures or movements.
Dystonia:
- Has many causes
- Can affect both children and adults
- Can lead to severe disability
Other kinds of movement disorders include:
- Ataxia, loss of muscle control in the arms and legs
- Atypical Parkinson’s, also called Parkinsonism, this condition causes symptoms similar to Parkinson’s disease, but the cause comes from trauma, stroke, or another condition.
- Dyskinesia. Abnormal, uncontrollable involuntary movements, usually of large muscle groups.
- Dysphonia. A voice disorder that causes muscle spasms in the voice box.
- Huntington’s disease. An inherited condition where neurons in the brain break down over time, leading to uncontrolled movements, loss of intellectual abilities, and emotional disturbances.
- Myoclonus. Quick, involuntary muscle jerks that are usually a symptom of another condition or infection. Myoclonus often occurs with neurologic conditions, such as epilepsy.
Diagnosing Movement Disorders
Movement disorders have similar symptoms and can be difficult to tell apart from each other. It’s important to get an accurate diagnosis because each specific condition requires a different treatment.
At Premier Health, our neurologists understand the differences among the movement disorders. Your doctor will:
- Perform a thorough physical exam
- Take a detailed medical history, including previous head injury or stroke, or exposure to toxins or drugs
- Discuss any family history of dystonia
Tests your doctor may order include:
- Balance and gait tests to check how well you can stand, walk and perform other walking tasks.
- EMG (electromyography). A measure of the muscle response to an electrical impulse.
- CT (computed tomography). X-rays and computer technology form a picture of the brain.
- MRI (magnetic resonance imaging). Magnets and radio waves create detailed images of the brain.
- DaT scans. A SPECT (single photon emission computerized tomography) imaging test that uses a radioactive tracer to show blood flow in the brain and help distinguish between essential tremor and Parkinson's disease.
Treatments For Movement Disorders
While there are no cures for movement disorders, treatments can reduce symptoms and improve quality of life. Options range from medicines and physical therapy to advanced neurosurgery.
Medicine. Medicines are the foundation of treatment for movement disorders. You may need a combination of medicines or you may need to change medicines if what your doctor prescribes stops working after a certain period of time.
Parkinson’s disease symptoms respond to different medications. Medicines can:
- Help the brain make more dopamine, which is lost in the disease
- Slow the loss of brain cells
- Mimic the function of dopamine
- Improve the function of other brain centers affected by less dopamine
Duopa infusion therapy treats motor fluctuations in Parkinson’s disease patients. Those in advanced stages of the disease may qualify for this leading-edge medicine treatment.
Essential tremor responds to several classes of medicines, including:
- Beta blockers
- Epilepsy medicines
Dystonia can be treated with:
- Oral medicines
- Botox (botulinum) injections into specific muscles to reduce or eliminate contractions
Therapy. Movement disorders can affect you physical movements and speech. Working with a therapist can help maintain your independence.
- Physical therapy. You work with a physical therapist to strengthen your muscles and achieve proper movement.
- Speech therapy. You work with a speech therapist to improve and maintain your speech.
MR-Guided Focused Ultrasound. If your tremors do not respond well to medication, MR-guided focused ultrasound may be an option for you. The Neuravive treatment uses focused sound waves guided by MRI to treat tremor, deep in the brain, with no incisions or permanent implants. It is a single procedure often performed on an outpatient basis.
Surgery. If medicine does not effectively control your movement disorder or the side effects from the medicine are not tolerable, you may benefit from surgery. Neurosurgery is also an option if severe tremors reduce your quality of life.
DBS (deep brain stimulation) is a type of neurosurgery that can control many movement disorder symptoms. DBS is not a cure, but it provides relief. A device called a neurostimulator (similar to a heart pacemaker) is implanted under the skin in your chest. Thin wire electrodes are placed in your brain and connected to the neurostimulator. Electrical impulses stimulate the brain and can improve tremor, stiffness, slowness, dyskinesia, medication wearing off and some types of walking problems. However, when the DBS device is turned off, your symptoms remain. Your neurologist will talk with you about whether DBS surgery is right for you.
Parkinson's Disease Clinical Trials
While there is no cure for Parkinson’s disease, essential tremor, or dystonia, stem cells and other therapies offer hope for the future. Clinical trials are an invaluable way to get involved in the pursuit of finding a cure or improving the quality of life for people with a movement disorder.
Talk with your doctor to find out if you are able to take part in a clinical trial.
The Premier Health and Wright State University Neuroscience Institute participates in the international Parkinson's Study Group for groundbreaking trials.
The group is:
- The largest nonprofit network of Parkinson centers in North America
- Plays a vital role in bringing innovative drugs to market changing the course of Parkinson’s disease with new medications
When you participate in a Parkinson's Study Group trial, you get access to medications not yet on the market — and all of your expenses are covered, including for medication, clinical visits, laboratory tests, and neuroimaging.
For information about clinical trials, contact the Clinical Neuroscience Institute at (844) 277-2894 (844) 277-2894.
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