Conditions We Treat

At the Movement Disorders and Neuromodulation Center, we treat a wide variety of conditions including:

Parkinson’s Disease

Parkinson’s disease is caused by loss of neurons in the brain that produce a neurotransmitter called dopamine. Parkinson’s disease is the most common cause of parkinsonism, which is a collection of symptoms including slowed movements, muscle rigidity, and tremor while at rest. These are the typical symptoms that most neurologists use to make a diagnosis of Parkinson’s disease. However, there are a broad range of other movement symptoms that can be caused by Parkinson’s disease, such as problems with balance, slowed walking, changes in facial expression, and changes in hand writing. There are also a number of non-movement symptoms associated with Parkinson’s disease, such as changes in sleep, mood, memory and thinking, bowel function, urinary function, vision, sense of smell, and blood pressure. Which symptoms develop and when is highly variable between individuals. The movement symptoms of Parkinson’s disease are usually responsive to medications that increase levels of dopamine in the brain or surgical treatments that target movement pathways in the brain. There are many treatments available that also help alleviate the non-movement symptoms. The treatment for Parkinson’s disease must be highly individualized as no two people with Parkinson’s disease experience it in the same way.

Essential Tremor

Essential tremor is one of the most common caused of an “action tremor,” or a tremor that emerges when doing things with the hands (rather than at rest). This tremor often runs in families. This type of tremor is typically present in both hands, but can also affect the voice or head. Because this tremor occurs with action, it can interfere with drinking, eating, writing, or using utensils. This type of tremor is usually not associated with other non-movement symptoms such as changes in mood or memory, but can be quite bothersome as it interferes with daily tasks. There are several effective treatments available for essential tremor, including medications and deep brain stimulation.


Dystonia is a condition caused by the abnormal contraction of muscles. It can affect the neck (causing the head to tilt or turn), hands, feet, or trunk. It can also be associated with specific tasks, such as writing or playing a musical instrument. Dystonia can be caused by certain medications, damage to specific areas of the brain, genetics, or for no clear reason at all. There are several possible treatments for dystonia, including medications or regular injections of botulinum toxin in the overactive muscles. In certain cases, deep brain stimulation can be helpful.


Ataxia is the neurologic term for problems with coordination and balance. The most common symptoms of ataxia are difficulty with walking and balance, swaying of the torso, changes in the voice, or difficulty accurately aiming fingers or toes at a particular target. Ataxia has many different causes (including nutritional deficiencies, genetic conditions, and autoimmune disorders) and requires a thorough diagnostic evaluation. The evaluation usually includes a detailed neurologic examination, bloodwork, and imaging of the brain. The treatment of ataxia depends on the underlying cause that is identified during this evaluation.

Chorea / Huntington’s Disease

Chorea is a movement disorder that includes involuntary movements of the hands, feet, and face often look fidgety or dance-like.  Chorea has multiple different causes, including:

  • Genetic disease (including Huntington’s disease and Wilson’s disease)
  • Brain injury (including stroke)
  • Autoimmune disorders
  • Medication side effect
  • Pregnancy

There are medications that can help treat the symptom of chorea. If the chorea is caused by an underlying disease that is treatable, addressing it may help the chorea.

The most common genetic cause of chorea is Huntington’s disease. Huntington’s disease is a genetic disease that typically causes three classes of symptoms: movement (most notably chorea), psychiatric, and cognitive. On average, symptoms typically start between ages 30-50 years old, but age of onset can vary between childhood through over 80 years old. There is no cure for Huntington’s disease. There are medications that can help with the movement and psychiatric symptoms.

The most common cause of chorea in children is Sydenham chorea, which is an autoimmune disorder that can develop after an episode of strep throat. The symptoms typically last for a few months, and often resolve on their own.

Tardive Dyskinesia

Tardive dyskinesia refers to the development of uncontrolled movements after someone is exposed to medications that affect the neurotransmitter dopamine. Most commonly, these are psychiatric medications, but can also include some anti-nausea medications as well. Tardive dyskinesia movements frequently include tongue movements, lip puckering or smacking, twisting / writhing movements of the neck, hands, or legs. Sometimes, these movements can improve after removing the medication causing them, but sometimes the movements can become permanent. The medications should only be stopped when advised by a doctor, as abruptly stopping them can worsen psychiatric symptoms or the movements themselves. There are additional medications that can be used to help treat the uncontrolled movements. For some times of movements that affect certain body parts (such as the eyelids), botulinum toxin injections can help. If medications do not help, severe tardive dyskinesia can be treated using deep brain stimulation (DBS).


Myoclonus refers to brief, shock-like jerks. Some forms of myoclonus occur in healthy people – for example jerks, that occur when falling asleep or waking up. Myoclonus has multiple different causes, including:

  • side effects from medications
  • kidney or liver disease
  • epilepsy
  • injury to the brain or spinal cord (including anoxic injury, which occurs when the brain is deprived of oxygen for a period of time)
  • genetic conditions 
  • neurodegenerative diseases (such as Alzheimer’s disease and multiple system atrophy)

Evaluation for myoclonus involves trying to understand what is causing the myoclonus. If the myoclonus is a side effect from medication or kidney/liver disease, it can be treated by addressing the underlying issue. Otherwise, myoclonus can be treated using medications, many of which are also anti-seizure medications.

Atypical Parkinsonism

Atypical parkinsonism (sometimes referred to as “Parkinson’s Plus syndromes”) are a group of conditions that look somewhat like Parkinson’s disease, but have other symptoms that are not typically seen with Parkinson’s disease. These disorders include multiple system atrophy (MSA), progressive supranuclear palsy (PSP), corticobasal syndrome (CBS), and dementia with Lewy bodies (DLB). Like Parkinson’s disease, atypical parkinsonism disorders are neurodegenerative diseases, where different proteins build up in the brain and cause brain cell injury. Atypical parkinsonism disorders may progress more quickly that typical Parkinson’s disease, and may not respond to Parkinson’s disease medications as well. There is no cure for any of the atypical parkinsonism diseases, though medications can help with some of the symptoms.

Multiple System Atrophy

Multiple system atrophy (MSA) is disease that sometimes has symptoms like Parkinson’s disease, such as tremor, slowness / stiffness, and balance difficulties. Some patients may also develop ataxia, which causes clumsiness and difficulty coordinating movements with the body. MSA also frequently affects the autonomic nervous system, which is the part of the nervous system that controls certain body functions like blood pressure, breathing, and urination. Symptoms of MSA include large changes in blood pressure when standing, urinary difficulties (such as urgency, incontinence, or retention), and erectile dysfunction. Some of these autonomic nervous system symptoms are also seen with typical Parkinson’s disease, but in MSA they usually develop earlier and are more severe.

Progressive Supranuclear Palsy

Progressive supranuclear palsy (PSP) causes stiffness and slowed movement, similar to Parkinson’s disease. PSP typically causes balance problems and falls, which are typically earlier and more severe than in Parkinson’s disease. Some patients have difficulties moving their eyes. As PSP progresses, some patients may develop difficulties with cognition (thinking / memory).

Corticobasal Syndrome

Corticobasal syndrome (CBS) causes stiffness and slowed movement, similar to Parkinson’s disease. CBS typically affects one side much more severely than the other. Other symptoms of CBS can include difficulty with language, a sensation that a limb does not belong to you (“alien limb phenomenon”), and changes with cognition.

Dementia with Lewy Bodies

In dementia with Lewy bodies (DLB), cognitive impairment is the most prominent symptom. People who have DLB typically have difficulty paying attention, organizing tasks, and driving. Some patients with DLB will develop hallucinations. Most patients with DLB will also show some signs similar to Parkinson’s disease, which can include tremor, slowed movements, stiffness, or walking difficulties. The symptoms of DLB often look similar to someone with advanced Parkinson’s disease who has developed dementia. In DLB, however, symptoms related to thinking occur earlier and more severely than in Parkinson’s disease.

Other movement disorders

The above categories represent both specific diseases but also broad categories of symptoms that can be from different specific diseases. For example, ataxia can be caused by a vitamin deficiency, stroke, or progressive genetic condition. In general, we can provide diagnosis, management and treatment of any condition that either affects movements/walking or includes classic “movement disorder” symptoms like tremor or ataxia.

Some more rare conditions that are not listed above and may not fall neatly into one category are:

  • Genetic conditions
    • Neurodegenerative:
      • Neurodegeneration with Brain Iron Accumulation (NBIA)
      •  Fragile X –Associated Tremor and Ataxia Syndrome
      • Neuroacanthocytosis
      • Dentatorubral-pallidoluysian atrophy (DRPLA)
      • ​​Pantothenate kinase-associated neurodegeneration (PKAN)
    • Non-Neurodegenerative:
      • Paroxysmal kinesigenic and non-kinesigenic dyskinesia
      • Dopa responsive dystonia
      • Wilson’s disease
  • Acquired Conditions
    • Functional Movement Disorders: Symptoms that cannot be explained by visible problems with the nervous system (i.e. no stroke, tumor, brain or spinal cord problem that can be identified) but that produce symptoms from problems with the functional connectivity of the brain.
    • Tics/Tourette Syndrome: Both psychiatrists and neurologists often treat tics or Tourette syndrome, which are characterized by frequent uncontrolled stereotyped movements. 
    • Restless Leg Syndrome and Periodic Limb Movements of Sleep
    • Infectious disorders: Some infections can cause movement symptoms (Whipple’s disease)
    • Cerebral palsy with associated dystonia or dyskinesia: Associated with known hypoxic perinatal event, often symptoms of dystonia/dyskinesia can develop over time.
    • Tremor/ataxia due to stroke or brain injury: Can develop some time after the actual brain injury.
    • Orthostatic tremor: Tremor that typically occurs in the legs upon standing.
    • Vitamin deficiencies/toxicities: There are some vitamin deficiencies that can produce classic neurologic symptoms, there are also many drugs both illicit, prescribed medications, and other toxic compounds not meant to be ingested that can cause problems with movement.
    • Autoimmune disorders affecting the central nervous system: There are some specific autoimmune condition that produce primarily neurologic symptoms (Stiff person syndrome). There can also be neurologic side effects to the systemic autoimmune conditions that affect the whole body.
    • Normal Pressure Hydrocephalus: Often effects walking and is associated with changes on brain MRI.