The subspecialty of movement disorders includes Parkinson's' disease, as well as a number of other conditions that affect the ability to move, speak or use one's hands. Some patients with movement disorders have excessive movements and/or abnormal postures, such as ticks, tremor, or dystonia (a weakened muscle state).
Parkinson's disease is a progressive disorder of the central nervous system affecting more than 1.5 million people in the United States. Clinically, the disease is characterized by a decrease in spontaneous movements, gait difficulty, postural instability, rigidity and tremor. Both men and women are affected. The frequency of Parkinson's disease is considerably higher for people ages 60 and older, even though there is an alarming increase in younger patients. In consideration of the increased life expectancy in this country and worldwide, an increasing number of people will be victims of Parkinson's disease.
Essential tremor is a very common but complex neurologic movement disorder. It is called "essential" because in the past, it had no known cause. Essential tremor is not caused by any neurological condition, nor is it the side effect of a medication. Essential tremor can cause shaking in the hands, head and neck; a shaking or quivering in the face, jaw, tongue, voice, trunk, and rarely, the legs and feet. The tremor may be a rhythmic "back-and-forth" or "to-and-fro" movement produced by involuntary (unintentional) contractions of the muscle. Severity of the tremors can vary greatly from hour to hour and day to day. Some people experience tremor only in certain positions— this is called postural tremor. A tremor that worsens while writing or eating is called kinetic or action-specific tremor. Most people with ET have both postural and kinetic tremor.
Only recently has the ability to place small electrodes in deep brain regions been refined enough to treat movement disorders. While we still perform both pallidotomies and thalamotomies, this newer use of deep brain stimulation (DBS) can be very effective in treating both Parkinson's disease and essential tremor (ET), as well as the movement disorders associated with multiple sclerosis and some types of dystonia. The stimulators can be fine-tuned to achieve maximum results. Unlike with older lesion techniques, in situations where the results are less than optimal, stimulators can be turned off or removed, if necessary. Lahey Hospital & Medical Center pioneered the first use of subthalamic nucleus DBS in the Boston area, and we continue to offer state-of-the-art techniques to patients with these problems. Neurosurgery leads the effort in movement disorder treatment, along with Diana Apetauerova, MD, Neurology.
The Movement Disorder Society National Parkinson Foundation Parkinson’s Disease Foundation We Move Tardive Dyskinesia Center American Society for Stereotactic and Functional Neurosurgery