Parkinson’s Disease and Movement Disorders

 

As many as one million people in the US and an estimated seven to 10 million world-wide live with Parkinson’s disease and other movement disorders. Whether you have a diagnosis or you are searching for answers, it is critical to find neurologists who specialize in the diagnosis and treatment of these conditions. The neurologists at UofL Physicians – Parkinson’s Disease and Movement Disorders are highly trained in diseases that affect physical movement, such as Parkinson's disease. Whereas a general neurologist may treat patients with any of more than 100 neurological conditions, the movement disorders specialists at UofL Physicians – Parkinson’s Disease and Movement Disorders focus on a handful of disorders allowing us to build extensive experience and expertise on the treatment of these diseases. In addition our partnership with the University of Louisville School of Medicine, the UofL Physicians – Parkinson’s Disease and Movement Disorders neurologists research and teach about movement disorders giving us access to world renown experts and state of the art treatments.

Movement disorders can be relentlessly progressive and disabling conditions. Untreatable a mere 50 years ago, there has been steady progress in the treatment of these conditions. Recent advances in our understanding of the mechanisms of these disorders have led to tremendous progress in treatment — both medical and surgical. The UofL Physicians – Parkinson’s Disease and Movement Disorders team are committed to advancing this progress and achieving our mission of improving the lives of patients suffering from these disorders.

At the UofL Physicians – Parkinson’s Disease and Movement Disorders our experts treat Parkinson's disease and other movement disorders.

Parkinson’s disease

Parkinson's disease is a disorder of the central nervous system that affects movement. The disorder results from the loss of cells in various parts of the brain, including a region called the substantia nigra. The substantia nigra cells produce dopamine, a chemical messenger responsible for transmitting signals within the brain that allow for coordination of movement. Loss of dopamine causes neurons to fire without normal control, leaving patients less able to direct or control their movement.

Huntington's disease and other choreic illnesses

Huntington's disease is an inherited disease that causes the progressive breakdown of nerve cells in the brain. Huntington's disease has a broad impact on a person's functional abilities and usually results in movement, thinking and psychiatric disorders.

UofL Physicians' Movement Disorders Clinic has been named a national Center of Excellence in treating Huntington’s disease by the Huntington’s Disease Society of America. HDSA Centers of Excellence provide an elite multidisciplinary approach to care and research. 

Patients at Centers of Excellence benefit from expert neurologists, psychiatrists, therapists, counselors and other professionals who have deep experience working with patients and families affected by Huntington’s disease, and who work collaboratively to help them plan the best program of care throughout the disease’s course.

Gilles de la Tourette syndrome and other tic-related illnesses

Tourette syndrome is a nervous system disorder that starts in childhood. It involves unusual repetitive movements or unwanted sounds that can't be controlled. For instance, you may repeatedly blink your eyes, shrug your shoulders or jerk your head. In some cases, you might unintentionally blurt out offensive words.

Dystonia

In dystonia, your muscles contract involuntarily — causing uncontrollable repetitive or twisting movements of the affected body part. Your symptoms may be mild or severe, and may interfere with your performance of many day-to-day tasks.

Tremor

Tremor is an unintentional, involuntary movement that and can affect the hands, arms, head, face, voice, trunk, and legs. There are many types of tremors but the two most common are Essential Tremor and Resting Tremor.

Essential tremor is a nervous system disorder (neurological disorder) that causes a rhythmic shaking. Essential tremor can affect almost any part of your body, but the trembling occurs most often in your hands — especially when you try to do simple tasks, such as drinking from a glass, tying shoelaces, writing or shaving. Essential tremor may also affect your head, voice, arms or legs.

The resting tremor, which is classically seen as a “pill-rolling” action of the hands that may also affect the chin, lips, legs, and trunk, can be markedly increased by stress or emotions. This tremor is most common in Parkinson’s Disease patients.

Myoclonus

Myoclonus refers to a quick, involuntary muscle jerk. For example, hiccups are a form of myoclonus. So are the sudden jerks, or "sleep starts," you may experience just before falling asleep. These forms of myoclonus occur in healthy people and rarely present a problem. They may also occur with Metabolic syndrome a disorder of energy utilization and storage, Neurodegenerative disorders such as Parkinson’s, Alzheimer’s, and Huntington’s or after cardiopulmonary arrest.

Ataxia

Ataxia describes a lack of muscle coordination during voluntary movements, such as walking or picking up objects. A sign of an underlying condition, ataxia can affect your movements, your speech, your eye movements and your ability to swallow.

Because no two cases are alike, the neurologists and treatment team at UofL Physicians – Parkinson’s Disease and Movement Disorders understands that when it comes to Parkinson’s disease, "state-of–the-art" treatment could mean a new exercise regimen for one person, medication for another and surgery for another. The key to determining the most effective treatment plan is to complete a comprehensive evaluation to understand the individualized needs of each patient.

Comprehensive Evaluation

At UofL Physicians – Parkinson’s Disease and Movement Disorders a comprehensive evaluation is the gold standard for diagnosing Parkinson's disease and other movement disorders. The experienced treatment team at UofL Physicians – Parkinson’s Disease and Movement Disorders partners with the patients’ family and/or caregivers to complete the evaluation using some or all of the following tests:

  • Health and family history: A discussion of symptoms; prior evaluations and treatment strategies; family history; medical history; and occupational or work history.
  • Examination: The neurologic examination includes an assessment of cognition (thinking and memory), movement, sensation, gait and balance.
  • Manual motor testing: Patients are asked to perform motor tasks, such as tapping their index fingers to their thumbs repetitively.
  • Videotaping: Diagnosing movement disorders relies heavily on the presence of certain movements that are assessed visually. Videotaping the movement helps with diagnosis and is an important part of the clinical record.
  • Neuropsychological testing: Changes in cognition and behavior are common in most movement disorders. A neuropsychologist conducts a series of paper and pencil tests to evaluate these functions.
  • Imaging tests: Imaging studies are often used in conjunction with other testing to rule out other conditions and/or detect typical signs of other movement disorders. This may include some of the following tests:
    • MRI and CT scans
    • PET (positron emission tomography) scans
    • Electrophysiological tests such as electroencephalogram (EEG) and electromyogram
    • DaTSCAN: A new test that measures dopamine in the brain and can be used to distinguish Parkinson's disease and parkinsonism from essential tremor
    • Laboratory studies: These can be helpful in the evaluation of movement disorders.

Medications

Medications can help you manage problems with walking, movement and tremors. Over time, however, the benefits of drugs frequently diminish or become less consistent, although symptoms usually can continue to be fairly well controlled. The key is constant monitoring and testing to ensure that the proper medications at the most appropriate level are administered to the patient.

Surgical Procedures

Deep brain stimulation. In deep brain stimulation (DBS), surgeons implant electrodes into a specific part of your brain. The electrodes are connected to a generator implanted in your chest near your collarbone that sends electrical pulses to your brain and may reduce your Parkinson's disease or tremor symptoms. At UofL Physicians – Parkinson’s Disease and Movement Disorders our neurosurgeons will determine when and if this surgery is an appropriate option.

Exercise and Physical Therapy

Exercise can help improve gait, balance, tremor, flexibility, grip strength and motor coordination in people with Parkinson's disease and other movement disorders. Our team can help patients connect with personal trainers and physical therapists who specialize in Parkinson's disease and movement disorders.

Research and Clinical Trials

UofL Physicians – Parkinson’s Disease and Movement Disorders experts are involved in research and clinical trials evaluating new treatment options for movement disorders. Through clinical trials, some patients can access experimental treatments that are not otherwise available.

Patient and Family Resources

At UofL Physicians – Parkinson’s Disease and Movement Disorders, our goal is to support the physical well-being of the patient and to alleviate the stressful "non-physical” aspects of living with these disorders. We also realize that the patients’ caregivers and family members may experience stress and even depression. As a result, additional support is offered including:

  • Written and verbal information about the disease.
  • Information about local, state, national, and international support groups that are available and are specific to the disease in question.
  • Access to the treatment team. Sometimes reassurance is all that a patient or caregiver needs, while other times they may have specific questions that need answering or general information about what to expect.
  • Education. The treatment team at UofL Physicians – Parkinson’s Disease and Movement Disorders teach patients how to combat the effects of Parkinson's disease and other movement disorders, how to take medications properly and how to integrate a wide variety of treatment options.
  • Psychosocial support. Patients may also have access to the center's full-time psychiatrist and neuropsychologist.

Physicians in this practice may not see patients at all locations listed below. For details, please call the appointment line for the location you are interested in visiting.

Offices and Clinics

  • UofL Physicians – Parkinson’s Disease and Movement Disorders, Frazier Rehab Hospital
    220 Abraham Flexner Way
    Suite 606
    Louisville, Kentucky 40202
    502-582-7654
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Hospital Affiliations

  • University of Louisville Hospital
  • Jewish Hospital
  • Frazier Rehab Institute

Parkinson's Disease and Movement DisordersUofL Physicians – Parkinson’s Disease and Movement Disorders is a practice within UofL Physicians - Neurosciences committed to advancing the development of new advancements and treatments that improve the lives of our patients and their families.

Our Louisville neurologists are researchers and professors in the University of Louisville School of Medicine. They are dedicated to not just being on the cutting edge, but defining the cutting edge in treatment for our patients.

Next Steps

For more information or to make an appointment,
call 502-588-6000