About Movement Disorders
Movement disorders include a variety of problems that originate in the brain and interfere with normal control of movement and activity. The most common of these problems is tremor, often called “essential” or sometimes “familial” tremor, followed by Parkinson’s Disease, which affects about 1% of people over age 50 in the United States. A group of conditions known as dystonia is also a movement disorder. These illnesses affect many aspects of a person’s life and can range in severity from mild and merely bothersome to severe and incapacitating.
Treatment and SURGERY
As is the case with many conditions, very mild movement disorders may require little or no treatment, while more disabling symptoms are treated with medication. The medical treatment of each type of movement disorder is different, and will often require the expertise of a neurologist or even a subspecialist. There are no available cures for movement disorders at this time, though research is ongoing. In many cases medication alone is not able to control all the symptoms, or may have side effects that are themselves disabling. Some patients affected in this way are candidates for surgery to help relieve their symptoms.
“Deep brain stimulation,” or DBS, is currently the state of the art method for surgical treatment and is safer than older techniques, as well as being more flexible and adjustable to the needs of each individual patient. DBS surgery can reduce the need for medication and improve the quality of life for many movement disorder patients.
The SENTA Approach
At SENTA we treat the patient, and not the disease. For movement disorders, this requires an integrated team approach that involves neurologists, neuropsychologists, neurosurgeons, physical therapists and others. We specialize in diagnosing, evaluating, and treating patients for whom surgery is an option. This can be a complex and confusing process for many patients—we place a priority on guiding our patients through this process to help each person make the best decisions and, in the case of surgery, have the best outcomes and greatest possible improvement in quality of life.
Patients are usually referred to us by their neurologists, but in some cases may be referred by a family physician or even come to us directly. Because of our team approach, patients who have not yet done so are all evaluated by a specially trained neurologist with extensive experience in the medical treatment of movement disorders. This ensures that all medical options have been considered. More importantly, patients who undergo surgery need the expertise of such a neurologist in order to make the best use of deep brain stimulation therapy. Testing by a neuropsychologist is also part of the evaluation process. Patients may then be referred for surgery, if necessary. Following surgery, patients continue with their neurologist and will also be referred for physical and occupational therapy evaluation in order to help make the most of their improved function.
DBS surgery involves the placement of tiny stimulating wires into specific locations in the brain in order to reduce abnormal movements and improve normal function. These wires are connected to a small pacemaker device which can be adjusted according to each patient’s needs. The entire system is under the skin and not visible from the outside; all the adjustments are done with a programming wand. This surgery is a delicate process that requires the patient to be awake and participating for part of the procedure.
Dr Jeffrey Schweitzer is a board certified neurosurgeon specializing in the treatment of movement disorders, epilepsy, and other diseases affecting the function of the nervous system. Trained at Harvard, UCLA, and Yale, Dr Schweitzer has been doing surgery for movement disorders for over 20 years and DBS surgery since 1997. He was among the first surgeons in California to use microelectrode recording during surgery, currently considered the standard of care, and has done over 800 DBS procedures, having directed the program at Kaiser in Los Angeles before coming to San Diego.