Movement Disorders Assessment and Treatment

Whether it develops slowly or suddenly, a movement disorder is characterized by uncontrollable body movements, lack of coordination, muscle tightness, or increasing difficulty in walking or using hands. Movement disorders are neurological and require an accurate diagnosis, along with options for treatment, in order for patients to remain in control of their bodies and lives.

The New Jersey Neuroscience Institute professionals, including neurologists, neurosurgeons, neuro-pathologists, physician assistants, nurse practitioners, neuro-psychologists, neuro-radiologists, rehabilitation specialists, nutritionists, social workers, audiologists, and physical therapists, are uniquely equipped to develop a comprehensive, individualized program of care that meets the specific needs of each patient and their families.  

Types of Disorders

The Institute’s multidisciplinary approach serves the varying medical, surgical and rehabilitation needs of patients with movement disorders such as:

• Essential tremor
• Parkinson's disease
• Multiple system atrophy (Shy-Drager, OPCA, striatonigral degeneration)
• Cortical-basal ganglionic degeneration (CBGD)
• Progressive supranuclear palsy (PSP)
• Atypical Parkinsonism (Parkinsonism-Plus)
• Dementia with Lewy bodies (diffuse Lewy Body Disease)
• Vascular (multi-infarct) Parkinsonism
• Blepharospasm
• Dystonia
• Hemifacial spasm
• Huntington's disease
• Myoclonus
• Tardive syndromes
• Tics/Tourette syndrome
• Normal Pressure Hydrocephalus with gait apraxia
• Intractable spasticity from spinal or cerebral origin

Causes

People of all ages are at risk for developing a movement disorder, although many of the disorders are typically associated with aging. Some common causes are:  

• Degenerative conditions (Parkinson’s, striatonigral degeneration, progressive supranuclear palsy, etc.)
• Heredity (Wilson’s disease, essential tremor, and certain dystonias)
• Infections
• Exposure to manganese, carbon monoxide or thallium
• History of stroke, head injury, or cerebral vascular disease

Diagnostic Services

An accurate diagnosis of a movement disorder relies on a combination of tests and a carefully documented history of the problem. A comprehensive diagnostic work-up at the NJ Neuroscience Institute is developed for each patient that may include some or all of the following:

• A comprehensive medical history
• A complete physical and neurological examination
• Blood tests (routine chemistries, CBC, ceruloplasmin)
• Magnetic Resonance Imaging (MRI)
• Magnetic Resonance Angiography (MRA)
• Functional MRI Scan
• Computed Tomography (CT) scans
• Lumbar puncture
• Autonomic testing

Treatment Options

After the comprehensive evaluation, the patient and the family are offered a list of treatment options tailored to the patient’s specific problems. These options range from optimizing medical therapy, injections, psychological evaluations, rehabilitation efforts, and surgery. They are aimed at improving the function and quality of life of the patient.

Medical Options:

• Adjusting current medications
• Adding new, standard medications
• Investigational medications
• Consulting a certified dietitian for nutrition therapy

• Botulinum toxins

• Evaluation by a rehabilitation specialist at the JFK Johnson Rehabilitation Institute
• Physical, occupational, or speech therapy

• Neuro-psychological evaluation for cognitive rehabilitation
• Psychological evaluation for mood disorders
• Social worker evaluation

• Stereotactic lesions, Thalamotomy or Pallidotomy
• Deep brain stimulationof the thalamus, globus pallidus, subthalamic nucleus
• Gamma Knife radiosurgery
• Programmable shunts
• Intrathecal Baclofen infusion therapy  

The NJ Neuroscience Institute has a close working relationship with specially trained therapists at JFK Johnson Rehabilitation Institute, also located on the JFK Medical Center campus, to provide the most complete care possible. Patients may be eligible for ongoing clinical trials.

If long-term care eventually becomes necessary, there are three JFK Hartwyck Nursing, Convalescent and Rehabilitation centers within the Solaris Health System, one of which is the first dedicated unit for individuals with Huntington’s disease in New Jersey. Each center offers skilled nursing and respite care in pleasant, comfortable surroundings and allows patients and their families to remain in communication with and close to the care of their NJ Neuroscience Institute physicians.

For a consultation with a neurologist or neurosurgeon or additional information, call (732) 321-7010.