Movement Disorders Clinic
The Movement Disorders Clinic offers therapeutic drug and surgical therapies for movement disorders, including Parkinson's disease, essential tremor, dystonia, and other neurological or movement disorders.
- Our multi-disciplinary team is equipped with special training to diagnose and treat a wide range of movement disorders.
- We are one of only a few facilities in this region to offer patients an innovative new surgical treatment called Deep Brain Stimulation, which delivers precise electrical impulses that greatly reduce tremors, rigidity, slowness of movement and stiffness.
- A nurse practitioner specializing in Parkinson's disease is available to patients at The Neurosciences Institute.
Description of Essential Tremor and Parkinson’s
A tremor is involuntary rhythmic shaking of the limbs or other parts of the body. It is the only symptom of essential tremor and one of four major symptoms of Parkinson’s disease. Parkinson's disease is a progressive neurological disease that affects a small area of nerve cells in an area of the brain near the neck. These cells, when working normally, produce a chemical substance called dopamine that coordinates smooth and balanced muscle movement. Parkinson's disease causes these cells to die. That leads to a lack of dopamine in the brain, which makes nerve cells fire out of control, causing patients to lose the ability to control their body movements.
Essential tremor is the most common neurological movement disorder in this country. The condition afflicts at least 1 million Americans, usually age 45 or older. Parkinson’s disease is a progressive and degenerative neurological disease that affects approximately 500,000 people in the United States.
Symptoms of Parkinson’s DiseaseMajor symptoms of Parkinson’s disease include:
- Muscle rigidity
- Bradykinesia (the slowing of movement and gradual loss of spontaneous activity)
- Changes in walking pattern and posture
- Changes in speech and handwriting
- Loss of balance and increased falls
Other more general symptoms can include depression, feelings of fear and anxiety, decreased facial expressions, difficulty swallowing and chewing, urinary problems or constipation, skin problems such as dandruff and sleeping problems.
No Known Cure for Parkinson’s Disease
There is no known cure or prevention for Parkinson's disease, so all efforts are focused on the management of the disease. Early diagnosis and appropriate treatment can allow most people with Parkinson's disease to live enjoyable, fulfilling lives.
Diagnosing Parkinson’s Can Be Difficult
Diagnosing Parkinson's disease is difficult since its symptoms are not always readily apparent and may be common to other medical conditions. Some imaging tests, such as a CT scan (computed tomography) or MRI (magnetic resonance imaging), may be used to rule out other disorders that cause similar symptoms. There are currently no laboratory tests available to diagnose this disease.
Given these circumstances, diagnosis is based on a rigorous physical examination that concentrates on the functions of the brain and nervous system. Tests are conducted on the patient's reflexes, coordination, muscle strength and mental function. As many as 40 percent of Parkinson’s patients are not accurately diagnosed for years. Prompt diagnosis is important because treatment decisions made early in the illness can have profound implications on the long-term success of the treatment.
Because the diagnosis is based on the physical examination of the patient, it is very important that the physician be experienced in evaluating and diagnosing patients with Parkinson’s disease. Our clinical team has completed special training in order to accurately diagnose all forms of movement disorders
Several forms of medication are available for Essential Tremor and Parkinson’s disease, as well as an innovative and effective new surgical treatment called Deep Brain Stimulation.
Treatments for Movement Disorders
Therapeutic Drug Treatments for Essential Tremor
Drug therapies for the treatment of essential tremor include beta-blockers and anticonvulsant medications that can be used alone or in combination to treat symptoms.
Approximately 50% to 70% of patients obtain some symptomatic relief from a beta-blocker called propranolol (Inderal®). Primidone (Mysoline®) an anticonvulsant medication related to phenobarbital, slows the central nervous system and helps to reduce or control seizure activity in more than half of patients.
Therapeutic Drug Treatments for Parkinson's Disease
Several types of therapeutic drug treatments are often used in combination to slow the progression of Parkinson’s disease and/or to improve symptoms.
Selegiline (Deprenyl®) is the medication most often used to slow the progression of Parkinson’s. It appears to work best when used early in the course of the disease and can be combined with other medications that mimic the role of dopamine in the brain and stimulate certain parts of the brain and nervous system for enhanced muscle control. Another new type of drug treatment offers the ability to block an enzyme that breaks down dopamine. This medication works in combination with other drug therapies to produce an overall improvement in patients’ symptoms.
Surgical Options - Deep Brain Stimulation
Robotic-guided Deep Brain Stimulation (DBS), or brain pacemaking, is a relatively new surgery for patients with Parkinson’s disease, Essential Tremor, and dystonia. DBS is a procedure which surgically implants a small battery-operated medical device called a neurostimulator that delivers electrical stimulations to targeted areas in the brain that control movement. Prior to your surgery, we will do imaging studies of your brain. These will be uploaded into the Mazor Robotics Renaissance® system’s 3-D preoperative planning software, allowing your surgeon to decide the best location for the neurostimulator and place it with ultimate precision and control. The electrical stimulations delivered by the neurostimulator can greatly reduce tremors, rigidity, slowness of movement and stiffness, and may also help balance problems. By decreasing tremors, DBS can help many patients reduce their medications and improve their overall lifestyle. DBS can be performed on patients of almost any age who are medically stable.
- Patients with involuntary movements caused by medications experience a more than 80 percent reduction in involuntary movements
- Freezing, or inability to move, is also markedly improved
- Most patients report a 50 percent improvement in their walking and balance
- Medications can often be reduced
Candidates for DBS
- Any patient with Parkinson’s disease, Essential Tremor, or dystonia whose symptoms cause a significant decline in quality of life and who has already undergone an adequate and reasonable use of medications and is in acceptable medical condition to undergo the surgery
For more information about The Neurosciences Institute at Morton Plant Hospital, please call (727) 461-8635.
The Neurosciences Institute
Ptak Orthopaedic & Neuroscience Institute
430 Morton St.
Clearwater, FL 33756