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NEUROLOGY & NEUROSURGERY SERVICES

Diagnosis & Treatment

Movement Disorders

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How are Movement Disorders Diagnosed?

Diagnosis

NewYork-Presbyterian’s movement disorder specialists perform a comprehensive assessment to determine what is causing your symptoms. You may have:

  • Physical and neurological evaluation to assess your symptoms and your ability to walk and perform other movements.
  • Vital parameter testing to assess your blood pressure and heart rate, both upon lying down/sitting and standing up.
  • Lab tests such as blood tests and sometimes a spinal tap to examine the cerebrospinal fluid.
  • Electromyography to evaluate muscle and nerve function.
  • Muscle biopsy to distinguish between muscle and nerve disorders.
  • Electroencephalography to look at brain activity.
  • Electrocardiogram to determine if your heart functions properly.
  • Structural imaging exams, such as magnetic resonance imaging (MRI) or computed tomography (CT) scanning, to search for anatomical abnormalities and exclude other possible causes of your symptoms, such as a brain tumor.
  • Functional imaging exams, such as positron emission tomography (PET) or single-photon emission computed tomography (SPECT), to search for metabolic abnormality that could explain your symptoms.

How Are Movement Disorders Treated?

Treatment

The symptoms of some movement disorders can be reduced using medications or surgery. Rehabilitation is a significant component of care for many patients.

Medications

Your symptoms may be decreased through the use of certain medications, such as:

  • Anti-seizure medicines to calm tremors
  • Anti-anxiety medications that relax the muscles
  • Acetylcholine blockers such as trihexyphenidyl and benztropine, which are sometimes used to mitigate tremor
  • Beta-blockers, heart medications that can reduce shaking and other symptoms
  • Dopamine-generating or dopamine-mimics medications, which are used to control symptoms in Parkinson’s disease and other Parkinsonian syndromes
  • Drugs that influence the effects of dopamine, such as tetrabenazine and levodopa
  • Botulinum toxin therapy (Botox®), a safe and effective treatment that relaxes affected muscles for several months and allows patients to maintain more normal posture and movement

Surgery

  • Deep brain stimulation (DBS) – DBS has become an important tool in the treatment of dystonia, essential tremor, and Parkinson’s disease — especially for people in whom nonsurgical therapies are not effective. NewYork-Presbyterian is one of the busiest and most prestigious centers offering this treatment. With DBS, neurosurgeons implant a device that acts like a pacemaker for the brain, reducing abnormal brain activity and minimizing spasms. DBS also enables many patients to reduce their dependence on medications, which over time may cause unpleasant side effects.
  • High-intensity focused ultrasound (HIFU) – NewYork-Presbyterian also offers magnetic resonance-guided high-intensity focused ultrasound, the most advanced precision treatment for patients with essential tremor and tremor-dominant Parkinson’s disease. This incision-free brain surgery uses focused sound waves to precisely target and destroy small areas of brain tissue that are causing symptoms. HIFU is associated with a quick recovery and return to daily activities. Our surgeons were the first in New York to offer this innovative treatment.

Other surgical approaches may be performed to interrupt the nerve pathways responsible for the abnormal movements experienced by people with dystonia. The surgeon may intentionally damage the deep centers of the brain responsible for abnormal movement or remove nerves at the point where they enter contracting muscles (selective denervation surgery).

Rehabilitation

Physical, occupational, speech, and nutritional therapy can be helpful to patients with movement disorders. Special equipment can help patients communicate effectively and remain mobile while ensuring their safety. Rehabilitation specialists are available at NewYork-Presbyterian to:

  • Evaluate muscle strength and motor skills and develop an individualized program to maintain existing physical function.
  • Recommend devices (including neck supports, canes, walkers, and wheelchairs) and equipment for the home to ensure patients’ safety and mobility.
  • Discuss ways to modify activities, conserve energy, and simplify work.

Some people find that complementary therapies (such as yoga, meditation, Pilates, biofeedback, and acupuncture) are also helpful in relieving their symptoms.

Get Care

Trust NewYork-Presbyterian for Movement Disorder Treatment

The neurology and neurosurgery experts at NewYork-Presbyterian understand the effects that the symptoms of a movement disorder can have on your life and the lives of your family members. We offer a range of therapies for every type of movement disorder, customizing a plan of care to meet your personal needs. Reach out to us today to set up an appointment.