Conditions We Treat
Movement disorders refer to a group of nervous system (neurological) conditions that can cause an excess of movements or a reduction of movements, which may be voluntary or involuntary.
The Rochester Regional Health Movement Disorders Program is staffed with experts committed to caring for and treating people afflicted with a wide range of movement disorders, including:
Ataxia
Ataxia is a disorder that affects the part of the brain that controls coordinated movement.
Symptoms: Ataxia may cause uncoordinated or clumsy balance, slurring of speech, vision problems and involuntary eye movements, difficulty swallowing, and difficulty with fine motor tasks (such as eating or writing).
Causes: Ataxia is caused by damage or degeneration in the back part of the brain called the cerebellum. Many conditions can cause ataxia, including alcohol misuse, certain medication, stroke, tumor, cerebral palsy, brain degeneration and multiple sclerosis. Inherited defective genes also can cause the condition.
Corticobasal Syndrome
Corticobasal syndrome, also known as corticobasal degeneration or CBS, is a rare disease in which areas of the brain shrink and nerve cells degenerate and die over time. The disease affects the area of the brain that processes information and brain structures that control movement. Corticobasal syndrome progresses over six to eight years.
Symptoms: Corticobasal syndrome may result in growing difficulty in movement on one or both sides of the body, poor coordination, trouble with balance, stiffness, involuntary muscle movements, difficulty swallowing, abnormal eye movements, or trouble with thinking, speech and language.
Causes: The cause of corticobasal syndrome are unknown, but research suggests that a protein in the brain called tau may play a role in the disease. A buildup of tau in brain cells may lead to their deterioration.
Dystonia
Dystonia is a movement disorder in which the muscles contract involuntarily, causing repetitive or twisting movements. Dystonia can affect one part of the body (focal dystonia), two or more neighboring parts (segmental dystonia) or all parts of the body (general dystonia). The muscle spasms can range from mild to severe.
Symptoms: Symptoms of dystonia may start slowly—you might notice that your handwriting is deteriorating or you may get cramps in the feet. Other symptoms may include eyelid twitching and speech difficulties.
Causes: The exact cause of dystonia is unknown but is believed to involve altered nerve-cell communication in several regions of the brain. Some forms of dystonia are inherited.
Huntington’s Disease
Huntington's disease is a genetic disease that attacks the brain, causing unsteady and uncontrollable movements in the hands, feet and face.
Symptoms: Huntington's disease usually causes movement, cognitive and psychiatric disorders with a wide spectrum of signs and symptoms. The early symptoms of Huntington disease are often general and may include irritability, depression, trouble learning new things, and forgetting facts. As the disease progresses, symptoms may include difficulty swallowing, uncontrolled movements, changes in speech, and loss of memory.
Causes: Huntington disease is a genetic disorder. It is passed on from parents to children. If a parent has Huntington disease, the child has a 50% chance of developing it.
Lewy Body Dementia
Lewy body dementia is a brain disorder in which protein deposits (called Lewy bodies) cause damage to nerve cells in areas of the brain that affect mental capabilities, behavior, movement and sleep.
Symptoms: This type of dementia involves progressive cognitive decline, combined with three additional defining features: (1) pronounced fluctuations in alertness and attention; (2) recurrent visual hallucinations; and (3) parkinsonian motor symptoms, such as tremors, rigidity, and balance issues.
Causes: Lewy body dementia is characterized by the abnormal buildup of proteins into masses known as Lewy bodies. This protein is also associated with Parkinson's disease. Factors such as age and family history may increase the risk of developing the disease.
Multiple System Atrophy
Multiple system atrophy (MSA) is a rare, degenerative neurological disorder affecting the body's involuntary (autonomic) functions, including blood pressure, breathing, bladder function and motor control.
There are three types of MSA:
- Parkinsonian, in which patients are affected mostly with severe symptoms similar to Parkinson’s disease such as slow movement, problems walking, stiff muscles and tremor
- Cerebellar, in which patients have problems primarily with coordination, walking and slurred speech
- Combined, in which patients suffer from both parkinsonian and cerebellar symptoms
Symptoms: In addition to the movement symptoms specific to each type of MSA, MSA can cause fainting and low blood pressure (as well as fluctuations in blood pressure), muscle contractions, urinary incontinence, constipation, sexual dysfunction, double vision or other vision disturbances, difficulty breathing and swallowing, sleep disturbances including sleep apnea, and abnormal sweating.
Causes: There is no known cause for multiple system atrophy (MSA). MSA causes deterioration and shrinkage (atrophy) of portions of the brain (cerebellum, basal ganglia and brainstem) that regulate internal body functions, digestion and motor control.
Parkinson’s Disease
Parkinson's disease is a progressive nervous system disorder that affects your ability to control movement. Symptoms start gradually, sometimes starting with a barely noticeable tremor in just one hand, and then worsen over time.
Symptoms: Symptoms of Parkinson’s disease and the rate of decline vary widely from person to person. The most common symptoms include: Tremors (shaking), slowness of movement (bradykinesia), muscle stiffness, unsteady walk and balance, coordination problems, muscle twisting, spasms or cramps (dystonia), stooped (hunched over) posture, decreased facial expressions. As the disease worsens, a patient may have trouble talking, sleeping, have mental and memory problems, experience behavioral changes and have other symptoms.
Causes: In Parkinson's disease, certain nerve cells (neurons) in the brain gradually break down or die. Many of the symptoms are due to a loss of neurons that produce a chemical messenger in the brain called dopamine. When dopamine levels decrease, it causes abnormal brain activity, leading to impaired movement and other symptoms of Parkinson's disease. The cause of Parkinson's disease is unknown, but several factors appear to play a role, including age, genetic mutations, and environmental factors.
Progressive Supranuclear Palsy
Progressive supranuclear palsy, also called Steele-Richardson-Olszewski syndrome or PSP, is a rare neurodegenerative disorder that damages the brain and affects how you walk, think, swallow and move your eyes. PSP frequently resembles Parkinson’s disease, often making it difficult to distinguish.
Symptoms: The most common symptoms are a loss of balance when walking or climbing stairs and an inability to aim your eyes properly (with particular difficulty looking downward). Other symptoms may include muscle stiffness, difficulty swallowing, problems with speech, sensitivity to light, sleep disturbances, mood imbalances, and memory problems.
Causes: The exact cause of PSP is unknown. However, PSP results from deterioration of brain cells in areas of your brain that control body movement, coordination, thinking and other important functions.
Tremor/Essential Tremor
Essential tremor is a nervous system (neurological) disorder that causes involuntary and rhythmic shaking. It can affect almost any part of your body, but the trembling occurs most often in your hands — especially when you do simple tasks, such as drinking from a glass or tying shoelaces.
Symptoms: Symptoms of essential tremor include uncontrollable shaking that occurs for brief periods of time. Shaking tends to begin gradually, usually more prominently on one side of the body, and worsen with movement. Other symptoms may include a shaking voice, nodding head, and in rare cases balance problems. Symptoms may be aggravated by emotional stress, fatigue, caffeine or temperature extremes.
Causes: The cause of essential tremor is unknown. However, in most people, the condition seems to be passed down from a parent to a child. If your parent has essential tremor, there is a 50% chance you or your children will inherit the gene responsible for the condition. Sometimes, ancillary testing such as brain imaging or genetic testing may help with the diagnosis.
Tourette Syndrome
Tourette syndrome, also called Tourette's disorder or Tourette’s, is a neurological condition characterized by motor and vocal tics. Tics are uncontrolled, rapid, sudden repetitive movements or sounds and they can range from mild to severe. Severe symptoms might significantly interfere with communication, daily functioning and quality of life.
Symptoms: Symptoms of Tourette syndrome often begin between ages 5 and 10 and may include motor or vocal tics. Motor tics may include eye blinking, head jerking, shoulder shrugging, nose twitching, mouth movements, or foot tapping. Vocal tics may include clearing the throat, coughing, sniffing, grunting, yelping or shouting.
Causes: The exact cause of Tourette syndrome is not known. However, early research suggests that it can be caused by a combination of inherited (genetic) and environmental factors. Chemicals in the brain that transmit nerve impulses (neurotransmitters), including dopamine and serotonin, may play a role.
Tardive Dyskinesia
Tardive dyskinesia (TD) is a neurological disorder caused by the long-term use of neuroleptic drugs. Neuroleptic drugs are generally prescribed for psychiatric disorders, as well as for some gastrointestinal and neurological disorders.
Symptoms: Tardive dyskinesia is characterized by repetitive, involuntary, purposeless movements. Features of the disorder may include grimacing, tongue protrusion, lip smacking, puckering and pursing, and rapid eye blinking. Rapid movements of the arms, legs, and trunk may also occur. Involuntary movements of the fingers may be present.
Causes: Neuroleptic drugs block dopamine receptors in the brain. Dopamine is a chemical that helps control emotions and the pleasure center of your brain. It also plays a role to in your motor functions. Too little dopamine may interfere with your muscles and cause the signs and symptoms of TD.