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Movement Disorder - GENERAL


  Introduction:

Movement disorders comprise a complex group of diseases and conditions that may cause involuntary movements (dyskinesias), abnormal muscle tone (dystonias), or postural disturbances. Disorders include tremor, chorea, athetosis, akathisia, hemiballismus, and myoclonus. Syndromes in which movement disorders are a major component of a generalized disease include parkinsonism, progressive supranuclear palsy, and the Shy-Drager syndrome.

Surgical Management of Movement Disorders:

Surgery is considered only after all attempts at conservative management have failed or provided suboptimal results. The type of surgery varies depending upon the particular movement disorder. In general, significant reduction of abnormal movement and/or tone can be expected in 80% of cases. The incidence of significant postoperative complications is quite low, on the order of 1 -5%.

Stereotactic Pallidotomy and Parkinson's Disease:

Other Movement Disorders and Operations:

Pallidotomy: Used Successfully for a condition referred to as dystonia which involves increased tone and associated abnormal posting of trunk and/or limbs.

Deep Brain Stimulation (DBS): FDA approved for use in Parkinsonian tremor and essential or familial tremor. This involves the permanent implantation of a stimulating electrode (picture) into an area of the brain called the thalamus.

Thalamotomy: This technique is very similar to pallidotomy though the target is in a different area of the brain.

Selective Rhizotomy:  With or without peripheral neurotomy or myotomy is used for torticollis which is a cervical form of dystonia that involves static or repetitive turning of the head.

Treatment:

  • Physical medicine and rehabilitation measures.
  • Surgical management.

Medical Therapies - A first step:

Presently, there is no known cure for movement disorders; however, there are new treatments and programs that are benefiting many individuals by improving the quality of their life. Generally, the latest medical therapies are pursued initially until they prove ineffective for the patient. Should these treatment programs not contribute sufficiently to enhance the quality of the patient's life, a surgical approach may be considered in consultation with the patient, the family and the neurological team of doctors.

Botox Injections - An available option:

Botox or botulinum toxin injection therapy is used to treat a variety of different neurological disorders.