Treatment for Parkinson's Disease and Movement Disorders

Contact our program coordinator at 646.704.1792 for full details.

The Parkinson's Disease Program at New York Methodist Hospital offers the only comprehensive diagnostic and treatment program for Parkinson's and other movement disorders in Brooklyn.

Parkinson's disease is a disorder of the central nervous system, involving the degeneration and loss of nerve cells in the basal ganglia of the brain. With the loss of these cells an individual loses the ability to coordinate normal movement.

There are many common symptoms of the disease, but there is no way of knowing which ones a patient will have, or in what order they will occur. The most characteristic feature of Parkinson's disease (which was once called "shaking palsy") is a slow and rhythmic tremor at rest. Usually the tremor begins in one hand and then later spreads to the other. Feet, legs, the lips and jaw may also shake.

Other common symptoms of Parkinson's include: rigidity in the limbs, neck or trunk, hypokinesia (slow movement which involves a decrease in both large and fine motor coordination), impaired gait, which may eventually result in slow, small, shuffling steps and balance problems, and impairment of posture, Parkinson's most disabling symptom, which generally occurs late in the course of the disease.

Parkinson's is a chronic disease; that is, once symptoms appear, it can be treated, but it will not go away. It usually progresses slowly, but the rate of progression varies from one case to another and is unpredictable. Because there is not yet a cure for Parkinson's disease and because there is no medication which can stop or slow the progression of symptoms, treatment is designed to suppress or reduce the symptoms that are present.

Medication Therapy

Medications are normally used when the disease symptoms result in a disability that interferes with daily activities. In most cases, medications will have a stronger impact at the beginning of the treatment, but will need to be increased or changed over time.

Sometimes, the medications eventually stop providing significant relief of symptoms. When this happens, surgical interventions in the basal ganglia can sometimes be used to alleviate some of these symptoms, particularly tremor, rigidity and dystonic muscle pain and, to a lesser extent, hypokinesia. The procedures done to alleviate Parkinson's disease involve the implantation of deep brain stimulators, which allow patients to control tremors with the touch of a small magnet.

Surgical Options: Deep Brain Stimulation

Patients with Parkinson's disease, who can no longer be helped with medication, can often be treated for tremors with deep brain stimulation (DBS). This involves the implantation of electrodes that are placed in a small region of the brain that contributes to the symptoms.

These electrodes are placed through a minimal opening in the skull. A computer-guided brain navigation system, along with microelectrode recording—a highly advanced brain mapping method--are used to maximize accuracy. The electrodes are then connected by wires to a type of pacemaker device (called a pulse generator) that is implanted under the skin of the chest, below the collarbone.

Once activated, the device sends continuous electrical pulses to the target areas in the brain, blocking the impulses that cause tremors. The stimulation can be turned on or off by the patient, with a hand-held magnet or an access control device. When necessary, the stimulator can be adjusted by the physician via a “remote control” device which works painlessly through the skin, thereby maximizing the benefits while minimizing the side effects.

Other Movement Disorders

There are a number of related movement disorders, sometimes called Parkinson syndromes or atypical "Parkinsonisms," as well as other unrelated movements disorders that are not considered Parkinsonisms.

The most common related Parkinson syndromes include progressive supranuclear palsy, which may cause gait disorders, frequent falls, visual abnormalities, speech or swallowing problems, and multiple systems atrophy, which is a lump term for several disorders that manifest with a slight tremor, gait and balance problems. Other involuntary movement disorders include hemifacial spasms, Huntington's chorea, Tourette's and other tic syndromes.

It is important to differentiate between these disorders and Parkinson's in order to plan treatment appropriately. Botulinum toxin injections are among the many treatments available for movement disorders. In some cases, deep brain stimulation surgery used to treat Parkinson's disease may also be a viable treatment for these movement disorders.

A Team Approach

Our team consists of neurologists who specialize in movement disorders, mental health professionals, neurosurgeons, speech pathologists,  nurses and physical and occupational therapists. Through interdisciplinary evaluations, our care team will provide each patient with a comprehensive treatment program specifically tailored to meet each person's needs.

For more information, please call 718.246.8820.

Click here to download a brochure about Parkinson's Disease.