Movement Disorders are a diverse group of diseases that result in the inability to produce willed physical movements or that result in involuntary movements such as tremors; they include neurologically based conditions such as Parkinson's disease, essential tremor, restless leg syndrome (RLS), Tourette syndrome, Huntingdon's disease, dystonia, ataxia, tics, dyskinesia, Lewy Body Dementia, tremor, Progressive Supranuclear Palsy (PSP), myoclonus, and chorea. Many of these conditions are characterized by either slow movement (bradykinesia) or lack of movement (hypokinesia) or too much movement (hyperkinesia).
Diagnosis
Evaluation and treatment of movement disorders can be challenging and complicated. The expertise of a Movement Disorder Specialist is unmatched by any other group of health care providers. The additional clinical training received by a movement disorder specialist will insure appropriate diagnosis and treatment. This is accomplished by keeping up with the latest knowledge in medical literature and attending scientific and educational meetings. Diagnosis is often made by conducting a thorough examination, obtaining an extensive medical history along with appropriate ancillary testing.
Treatment
Many patients can obtain symptom control and management through medications and lifestyle changes. A fellowship trained Movement Disorder Specialist is aware of and remains updated on the latest advances in medications, research, surgeries, therapies, and allied services that will best serve the needs of these patients. Evaluation and adjustment of medications is an on-going part of treatment. With appropriate symptoms, Botox injections are utilized to alleviate symptoms. When pharmacological interventions have been exhausted, we can evaluate the potential for appropriate surgical interventions and make recommendations and referrals.
Surgical Treatment Options
Surgical intervention is offered to some patients. Deep Brain Stimulators (DBS) have been available and used successfully for over ten years. Following an extensive work up, tiny electrodes are placed in a specific region of the brain and attached to a small device (similar to a cardiac pacemaker). The device delivers undetectable electric shocks to control tremor for both Parkinson's and Essential Tremor patients. Periodic adjustments to the DBS unit can be done in our office in a routine office visit.
Additional types of brain surgery are other options for tremor control. Patients who are surgical candidates undergo extensive pre-surgical testing and evaluations. All of these surgical interventions can be done at York Hospital by fellowship trained neurosurgeons.
Programs
In addition to medications, we offer an array of programs for the movement disorders patient:
- Physical therapy
- Aquatic therapy
- Occupational therapy
- Neuropsychological evaluations
- Music therapy
- Neuromuscular massage
- Palliative care consultations
- Nutritional consultations
- Psychological counseling
- Caregiver resources
- Speech therapy
- Conventional exercise classes
- Tai chi
- Strength training
- Dance therapy
- Neuro ophthalmology
- Rehabilitation program
- Pastoral care
- Complementary medicine
- Sleep disorder evaluations
Support
Our team partners with the National Parkinson's Foundation, The International Essential Tremor Foundation, and the Dystonia Foundation to provide education and up to date information to our patients. We hold an annual Parkinson's Symposium as a public forum for patient and community education. Recognizing that individual support is vital, there is a coordinator available to answer questions or direct you to appropriate resources. And, acknowledging that a Movement Disorder and its treatment can impact the entire family, we offer both a patient and a caregiver support group. We maintain a Resource Room, stocked with books, DVDs, tapes, flyers, posters and pamphlets all aimed at educating patients and their families.
Speech Therapy
WellSpan offers multiple opportunities for persons with Parkinson’s disease to improve and maintain their speech and voice skills. Did you know that almost 90 percent of people with Parkinson’s will experience difficulty with their speech at some time during the course of their disease? Many may also experience difficulty with swallowing.
SPEAK OUT!® and LSVT Loud® are two programs which offer individual therapy to help persons with Parkinson’s to improve their speech and swallowing function. Both are research-based methods which have been shown to be effective at improving both swallowing and speaking through guided exercises.
These programs are offered at WellSpan Rehabilitation at Apple Hill, Bannister Street, Queensgate, WellSpan Surgery & Rehabilitation Hospital and Wheatlyn.
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