Movement Disorders
Movement disorders are neurological conditions that affect the body’s ability to control or initiate movement. Movement disorders can cause difficulties performing everyday tasks, even down to dressing, drinking a cup of coffee or using a pen. Three of the most common movement disorders are Parkinson’s, Dystonia, and Essential Tremor.
Diagnosis and Treatment
If you think you are suffering from movement disorders, your family doctor will most likely refer you to a neurologist. He or she will perform a general physical examination. Most probably, further technical examinations are necessary, such as:
- Electrophysiological examinations
Neurography, electromyography, sensory evoked potentials, MEP or tremor analysis,
- Examination of the cerebrospinal fluid (CSF) to rule out an infection,
- Imaging procedures such as computer tomography and MRI to detect structural changes in the brain or spinal cord.
These tests may only be possible in a specialised centre or clinic. Your neurologist will advise you on this and refer you if necessary.
- The diagnosis of Parkinson’s disease in particular is a diagnosis of exclusion, which means that diseases with similar symptoms must first be ruled out as the cause of the problem. In addition, it is usually checked whether the person affected responds to Parkinson’s medication such as levodopa and the symptoms then improve.
Parkinson’s is a progressive disease. This means that the symptoms increase over time and after a certain point can no longer be controlled only with medication.
Fortunately, there is another treatment option in the form of Deep Brain Stimulation (DBS).
There is an ideal “window” for getting DBS therapy – and a point at which it’s too late to have the procedure. In general, the best time to begin DBS treatment is when you’re still responding to levodopa, but are no longer able to control motor symptoms with medication alone. This point varies from person to person, but is about four years after diagnosis.1
1. Engl J Med 2013; 368:610-622 DOI: 10.1056/NEJMoa1205158
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