Movement Disorders (Parkinson’s Disease)
Movement disorders are neurological conditions that affect the speed, fluency, quality and ease of movement. They may involve excessive or involuntary movements or slowed or loss of voluntary movements. Movement disorders occur as a result of damage or disease in a region located deep in the brain. These clusters of nerve cells send and receive electrical signals and are responsible for movement control. Some of the most common movement disorders include: Parkinson's disease, essential and familial tremor, restless leg syndrome, Huntington's disease, Tourette's syndrome and dystonia. While there is no cure for these diseases, their symptoms can be treated effectively for years with the use of medications or surgery.
The Nebraska Medical Center Movement Disorders Clinic, the most comprehensive in the Midwest, is helping restore independence and quality of life to many patients who thought they had to live with the debilitating effects of excessive or involuntary movement disorders.
Essential tremor is the most common of all neurologic diseases with the exception of stroke, affecting as many as one in 20 people over age 40 and one in five people over 65. It often runs in families, but can also occur without a family history. The condition most often causes tremor in the hands, head or voice. The disease is sometimes confused with Parkinson's disease. However, unlike Parkinson's disease, essential tremor does not affect other aspects of movement and does not lead to serious complications.
Symptoms of essential tremor often become worse with fatigue, stress and sleep deprivation. If lifestyle changes are not successful at relieving symptoms, several medications are available that provide relief. In individuals whose tremors are severely debilitating and medications are not effective, ablation surgery or deep brain stimulation surgery may be effective options for treatment. Both types of procedures are offered at The Nebraska Medical Center.
Huntington's disease is a progressive, neurodegenerative disease that results in uncontrolled movements, emotional disturbances and mental decline. Huntington's disease always runs in families and does not skip generations. It is associated with a genetic mutation. Individuals have a 50 percent chance to inherit the genetic mutation from their parent, and if they inherit the genetic mutation, they will develop the disease. The disease affects both males and females and symptoms usually begin in middle age. Individuals who develop symptoms at an earlier age, are more likely to have more severe symptoms that progress more quickly.
While there is no cure for Huntington's disease and it is ultimately fatal, there are medications that can be used to control some of the symptoms.
Parkinson's is a common progressive neurodegenerative disease that affects regions of the brain that control movement. It usually develops after age 50, although it can affect people as young as 20 to 30 years old. The symptoms of Parkinson's disease include tremor (shaking), muscle stiffness, difficulty walking, slowness of movements and problems with balance and coordination. As the disease progresses, these symptoms worsen and make daily activities like eating, drinking, writing and walking very difficult. These symptoms often progress slowly and get worse over a 10 to 20 year period, but they can also progress more rapidly, especially when symptoms start at a younger age.
There are a number of different medications that can be used in the treatment of Parkinson's disease. The drug levodopa, also called L-dopa, has been the most effective means of treatment for many years. However, after long-term use, complications may develop that are often very debilitating. Other medications called dopamine agonists, are also very useful and can be used either alone or in combination with levodopa. Surgical procedures such as ablation or deep brain stimulation can be helpful in patients with advanced disease that either cannot tolerate medications because of side effects or have developed complications of treatment with medications such as levodopa. Both types of procedures are offered at The Nebraska Medical Center.
Individuals with restless legs syndrome have difficulty sitting or lying for long periods of time due to discomfort in their legs that is experienced at rest. This discomfort is relieved by movement. The condition can begin at any age, affects both sexes and may worsen with aging. The cause of restless leg syndrome is unknown. In up to half of cases, restless leg syndrome has been found to run in families. Restless leg syndrome sometimes accompanies common conditions such as neuropathy, diabetes, kidney failure or iron deficiency. In these cases, symptoms tend to develop more rapidly.
Individuals with underlying conditions will often get relief from their symptoms by treating the underlying condition. If there are no associated conditions, treatment focuses on lifestyle changes and medications. There are several medications available that have been found effective in treating restless legs symptoms.
Tourette's syndrome is a disorder that causes involuntary behaviors called tics. Tics can be brief, repetitive, simple or complex movements and vocalizations for which people have very little control. For instance, these individuals may repeatedly stamp their feet, blink their eyes, shrug their shoulders, repeat others or cough or sniff continuously. Some may even shout obscenities. With great effort, some of these behaviors may be suppressed for a period of time, but eventually they will need to be expressed. The symptoms usually begin in childhood and are often outgrown by adolescence. The condition is more common in males.
Most people with Tourette's syndrome don't require medications. However, if symptoms interfere with their ability to function, there are several medications that may help control symptoms.
Dystonia is characterized by sustained muscle contractions which cause abnormal postures, repetitive movements, or twisting. These involuntary movements may be painful and may affect a single muscle, a group of muscles, or the entire body. They may present in a variety of ways, such as voice tremors, foot cramping, or neck twisting. Dystonias may be generalized, affecting much of the body, or focal, localized in a specific place.
The various treatment strategies for dystonia include certain oral medications, botulinum injection, surgery, as well as physical, occupational and speech therapy.
To make an appointment with a movement disorder specialist at The Nebraska Medical Center please call 800-922-0000 or visit the Find a Physician link.
- John Bertoni, MD
- Harris A. Frankel, MD
- Daniel Murman, MD
- Diego Torres-Russotto, MD
Private Practice Physicians
- John F. Aita
Goldner, Cooper, Cotton, Sundell, Franco and Diesing
- Ronald A. Cooper, MD
- Joel T. Cotton, MD
- T. Scott Diesing, MD
- David A. Franco, MD
- John Goldner, MD
- Robert Sundell, MD
Neurology Consultants of Nebraska
- Scott H. Goodman
- Pamela M. Santamaria