Overview

Overview

Cleveland Clinic’s Center for Neurological Restoration — focused on a single goal of advancing treatment through ongoing basic and clinical research — is nationally recognized for expertise in medical management and innovations in the surgical treatment of movement disorders (Parkinson's disease, Huntington's disease, Essential tremor, Dystonia, Tourette's syndrome, Ataxia, Restless legs syndrome, Gait Disorders, Myoclonus and Chorea) as well as psychiatric disorders such as obsessive-compulsive disorder and depression.

Podcasts

Understanding Parkinson’s Disease

Hubert Fernandez, MD, Cleveland Clinic Movement Disorders Specialist

The Center for Neurological Restoration brings together physicians and researchers for the comprehensive management and study of movement disorders, including Parkinson disease, essential tremor and dystonia, chronic pain and headache.

The center is nationally recognized for innovations in the treatment of movement disorders and a world leader in deep brain stimulation (DBS), which is routinely used for Parkinson disease, essential tremor and some forms of dystonia.

Staff at the center are also studying how DBS may alleviate other conditions, including obsessive-compulsive disorder, major depression, some forms of chronic pain, and weakness following stroke.

Other points of distinction include:

The Center for Neurological Restoration also offers deep experience in spinal cord stimulation for refractory pain syndromes, including revision surgery. All these activities are supported by a broad research portfolio comprising diverse clinical trials and multiple laboratory investigations.

What We Treat

What We Treat

Movement Disorders

Headache and Chronic Pain Disorders

Pain Medicine

  • Interventional Procedures
    • Botox for headaches
    • Celiac plexus blocks
    • Combination of interventional procedures with intensive rehabilitation measures
    • Discography
    • Epidural Steroid injections
    • Facet injections
    • Intrathecal drug delivery
    • Knee, hip and joint injections
    • Lumbar sympathetic block
    • Neurolytic injections
    • Occipital nerve stimulation for headaches
    • Peripheral nerve blocks, including genitofemoral and inguinal nerve blocks
    • Peripheral nerve stimulation
    • Radio frequency ablation
    • Spinal cord stimulation
    • Splanchnic block
    • Stellate and sphenopalatine ganglion blocks
  • Psychophysiological Pain and Stress Management
    • Biofeedback-assisted pain and stress management
    • Educational classes about chronic pain and its treatment
    • Guided imagery
    • Individual or group counseling
    • Specialized groups for conditions such as abdominal pain and fibromyalgia
  • Medication Management
    • Anti-inflammatory
    • Membrane stabilizers
    • Opioids
    • Serotonin-norepinephrine uptake inhibitors
    • Sympathetic blocking agents
  • Physical Therapies
    • Functional capacity evaluations
    • Land and water based treatments
    • Personalized treatment plans to help patients move from pain, disability, and suffering to wellness and independence
  • Occupational Therapies
    • Assistance in addressing activities of daily living, including home and work
    • Ergonomic evaluation
  • Interdisciplinary Pain Rehabilitation
  • Chronic Pain and Addiction
    • The burden of pain is greater in the presence of addiction. We have a great deal of experience in evaluating and educating patients who suffer from this disease complex and in arranging appropriate treatment for them.

Headache and Facial Pain

Infusion Center
The nurse clinician is also in charge of our infusion suite, a treatment room devoted to intravenous infusions specific for headaches. Cleveland Clinic’s Headache and Facial Pain Clinic pioneered the development of the headache infusion service several years ago as a means to provide urgent, inpatient-type care to patients who would otherwise have visited an emergency room.
This room, which is available Monday through Friday, 8 a.m. – 4:30 p.m., is under the guidance of our staff physician, and provides “same day” care for patients already in the CCHC program or patients new to the program. It also provides an accessible site for initiation of analgesic research studies and analgesic treatment programs.

In the latter regard, the infusion suite successfully functions as a site where patients can be detoxified from medications that perpetuate headaches. It functions as an alternative to hospitalization. Combined with innovative approaches developed at Cleveland Clinic, the headache team has successfully treated many chronic headache patients as outpatients.

Home Care Infusion Nursing
This service can be provided in an outpatient setting, allowing the patient to stay at home or at work, while still receiving aggressive medical therapy for headaches.

Physical Therapy
Physical therapists work closely with the Headache and Facial Pain Clinic where they employ their knowledge of anatomy, biomechanics, and ergonomics to assess and treat mechanical factors contributing to headaches. Therapists will assess mobility of the neck and upper body, posture, and physical environment of the home and work. Pain response to repeated movements and sustained positions is evaluated, and the patient’s general condition and activity level are considered.

Treatment focuses on educating and empowering the patient to participate in techniques and specific exercises to correct mechanical problems.

Dietary Therapy
A registered dietitian is available to analyze and review a patient’s eating patterns and medical history as they relate not only to the headache disorder but also to the patient’s general lifestyle and individual needs.

Our Doctors

Our Doctors

Appointments

Appointments

Make an Appointment

To make an appointment, please call locally at 216.636.5860 or toll-free at 866.588.2264.

For general questions about treatment options in the Section of Pain Medicine,
call the unit locally at 216.444.2423 or toll-free 800.223.2273 ext. 42423.

For questions related to insurance or reimbursement, call the Admissions Coordinator
locally at 216.444.5433 or toll-free 800.223.2273 ext. 45433.

Locations:

Refer a Patient

DrConnect: Online Tool for Referring Physicians

DrConnect is a complimentary online tool for referring physicians that offers secure access to their patients' treatment progress at Cleveland Clinic.

MyChart

View portions of your medical record, see test results, renew prescriptions, request appointments and more.

Medical Concierge

Cleveland Clinic’s Medical Concierge program is a complimentary service for patients who travel to Cleveland Clinic from outside Ohio. Our patient care representatives facilitate and coordinate the scheduling of multiple medical appointments; provide access to discounts on airline tickets and hotels, when available; and make reservations for hotel or housing accommodations

For more information about the Medical Concierge program:

  • Call toll-free 800.223.2273, ext. 5558
  • Visit the Global Patient Services Center
  • Email medicalconcierge@ccf.org
  • Clinical Trials

    Clinical Trials

    Huntington's Disease Clinical Trials

    Refer to the questions below to learn more about our current Huntington's Disease clinical trials.

    Do you or a family member have Huntington's Disease (HD)?

    Cleveland Clinic is conducting a clinical research study to collect information and biological samples from HD patients and their family members to learn more about HD and to try to find new treatments for the disease.

    Approximately 15,000 people are anticipated in this trial that is being conducted at approximately 200 research centers across the 30 countries.

    Cleveland Clinic Main Campus (Cleveland, OH) and Cleveland Clinic Lou Ruvo Center for Brain Health (Las Vegas, NV) are participating in this research study.

    The study involves yearly office visits with a neurologist and research personnel.

    If you are interested in learning more about this trial, please contact study coordinator Suzanne Mazhuvanchery at 216.445.5637 or email cnrresearchreferrals@ccf.org and reference study: Enroll-HD.

    You can also find additional information on this trial at:

    Parkinson's Disease Clinical Trials

    Refer to the questions below to learn more about our current Parkinson's Disease clinical trials.

    Do you have Parkinson's Disease (PD) experience "OFF" time?

    The Cleveland Clinic Main Campus is conducting a clinical research study to determine if an investigational drug, a fast-acting formulation of apomorphine that is placed under the tongue, is safe and effective in decreasing "OFF" time in PD patients already taking levodopa.

    Approximately 126 patients are being recruited for this trial – 4 at the Cleveland Clinic Main Campus.

    The study involves up to 13 visits to the Cleveland Clinic Main Campus over approximately 4.5 months.

    Main Inclusion Criteria

    • At least 18 years of age with PD
    • On levodopa therapy with continued benefit
    • More than 2 hours "OFF" time per day

    Main Exclusion Criteria

    • History malignant melanoma
    • Cankers or mouth sores
    • Previous treatment with neurosurgical procedures for PD or continuous subcutaneous apomorphine infusion; or Duodopa/Duopa

    If you are interested in learning more about this trial, please contact study coordinator Alexandria Wyant at 216.444.1179 3 or email cnrresearchreferrals@ccf.org and reference study: CTH-300.

    You can also find additional information on this trial at:

    Are you over the age of 60 with a reduced smell but do NOT have Parkinson's Disease (PD)?

    Cleveland Clinic's Main Campus is working with The Michael J Fox Foundation on a clinical research study called The Parkinson's Progression Marker Initiative (PPMI). The goal of PPMI is to identify and assess biomarkers in people who are at risk to develop PD as well as those with typical PD symptoms. The PPMI project has various sub-studies, including one looking for non-PD patients with a reduced sense of smell.

    While most people with a reduced sense of smell will not develop PD, the majority of PD patients do have reduced sense of smell. This loss of smell often begins several years prior to the onset of motor symptoms like tremor or stiffness.

    You qualify to participate in this PPMI sub-study if you are over the age of 60 with a reduced sense of smell and no PD diagnosis.

    The study involves up to 48 months of participation. There are approximately six visits in the first year and then a visit every 6 months until completion.

    If you are interested in learning more about this trial, please contact study coordinator Jennifer Mule at 216.444.1134 or email cnrresearchreferrals@ccf.org and reference study: PPMI.

    You can also find additional information on this trial at:

    Do you have Parkinson's Disease (PD) and are considering deep brain stimulation (DBS) as a treatment option?

    Cleveland Clinic Main Campus is recruiting for a clinical research study that being done to evaluate the safety and effectiveness of Boston Scientific’s implantable DBS system in advanced PD patients with levodopa-responsive PD that is not being adequately controlled by medication. The goal of this system is to improve the number of waking hours per day with good symptom control and no troublesome dyskinesia (involuntary movements).

    Approximately 310 PD patients are being recruited for this trial with approximately ten (10) anticipated at the Cleveland Clinic Main Campus.

    The study involves approximately 12 scheduled visits to the Cleveland Clinic Main Campus during Year 1with yearly visits through Year 5.

    Main Inclusion Criteria (patients who may be eligible to participate)

    • Between the ages of 22-75
    • Diagnosed with PD at least five (5) years ago
    • Have symptoms of resting tremor (trembling or shaking), rigidity (stiffness) or bradykinesia (slowness of movement)
    • Willing to travel to CCF main campus for frequent visits

    Main Exclusion Criteria (patients who may not be eligible to participate)

    • Ay medical or neurological condition that puts you at surgical risk
    • Any significant psychiatric condition
    • Current substance abuse

    If you are interested in learning more about this trial, please contact study coordinator Alexandria Wyant at 216.444.1179. or email cnrresearchreferrals@ccf.org and reference study: INTREPID

    You can also find additional information on this trial at:

    You can also download our flyer below:

    Intrepid

    Do you have Parkinson's Disease and experience periods where your medication isn't working?

    The Cleveland Clinic Main Campus is conducting a clinical research study to determine the effectiveness of an investigational drug, tozadenant, to decrease "OFF" time in PD patients already taking levodopa.

    Approximately 450 are being recruited for this trial – 6 at Cleveland Clinic Main Campus.

    The study involves 14 visits to the Cleveland Clinic Main Campus over approximately 1.5 years.

    Main Inclusion Criteria

    • Between the ages of 30-80 with Parkinson's Disease for at least 3 years
    • On levodopa therapy at least 4 times per day with continued benefit
    • Currently taking a secondary Parkinson’s Disease medication ( ex. Amantadine)
    • At least 2.5 hours "OFF" time per day

    Main Exclusion Criteria

    • History of surgical intervention for PD
    • Low blood pressure when standing up that requires medication
    • Known diagnosis of Malignant Melanoma

    If you are interested in learning more about this trial, please contact study coordinator Yvette Pitchford at 216.445.7513 or email cnrresearchreferrals@ccf.org and reference study: TOZ-PD

    You can also find additional information on this trial at:

    Headache Clinical Trials

    Refer to the information below to learn more about our current headache clinical trials.

    Are you a working adult diagnosed with episodic migraine?

    Cleveland Clinic's main campus is conducting a clinical research study to compare the effectiveness of an FDA approved medication, Treximet, vs. other standard Triptan medications for migraine management.

    Approximately 60 patients will be enrolled into this study.

    The study involves three (3) visits to the Cleveland Clinic Main Campus as well as phone calls with research personnel.

    Main Inclusion Criteria

    • At least 18 years of age with migraine diagnosis before age 50
    • Migraines for at least one year
    • Currently employed and taking triptan medication, such as Imitrex, for migraine management

    Main Exclusion Criteria

    • History of stroke, heart attack or uncontrolled high blood pressure
    • Allergy to aspirin or naproxen
    • Pregnant or nursing

    If you are interested in learning more about this trial, please contact study coordinator Michael Zeleny at 216.445.1861 or email zelenym@ccf.org and reference study: Treximet.

    For Medical Professionals

    For Medical Professionals

    Publications

    Please download a copy of one of our DBS screening publications below

    Comprehensive, Multidisciplinary Deep Brain Stimulation Screening for Parkinson Patients: No Room for "Short Cuts"

    Huntington's Disease Guide for Providers

    The Center for Neurological Restoration is focused on advancing treatment of HD through ongoing basic and clinical research, expertise in medical management, and surgical restoration and innovation. Please download our guide below to learn more.

    Huntington's Disease Comprehensive Care Clinic

    Referrals

    Find resources for referring physicians, including physician consults, transfers and a liaison service.

    DrConnect

    Stay connected to patients you refer to Cleveland Clinic through online updates and electronic medical records.

    CME Programs

    The Center for Continuing Education is responsible for one of the largest and most diverse CME programs anywhere in the world. We offer live CME courses and free online CME activities.

    Career opportunities

    Thank you for your interest in the career opportunities with the Neurological Center for Pain at Cleveland Clinic. We are a not-for-profit, multispecialty academic medical center that integrates clinical and hospital care with research and education. Cleveland Clinic is highly defined by its faculty physicians, scientists, nurses, allied health professionals, and technical and support staff.

    Available positions:

    Resources

    Resources

    Videos

    Cleveland Clinic's Center for Neurological Restoration provides a variety of educational materials for patients to learn more about services, disease information and more. Here you will find videos, podcasts, downloadable pdf's as well as current happenings involving the Neurological Restoration Center.

    Video topics:
    • Deep Brain Stimulation
    • Deep Brain Stimulation for Parkinson's Disease
    • Headaches, Migraines, and Chronic Pain.

    Essential Tremor Support Group

    Many people have experienced shaky hands, but for 10 million Americans, essential tremor is a constant problem. We hope you can join us for a support group dedicated to people living with essential tremor.

    For patients, caregivers, family members and friends.

    Please register by calling 216.444.2685 or email ehrmanb@ccf.org.

    Webchat Transcripts

    Headache & Facial Pain


    Young Onset Parkinson's Disease Support Group

    Mission Statement

    Our mission is to establish the optimal quality of life for the Northeast Ohio community by providing support, information, and advocacy to improve the lives of those with young onset Parkinson’s and those who care about them. We achieve our mission through public awareness, education, advocacy and supporting research until a cure is found. Our goal is to help you be informed, live well and stay strong.

    About Parkinson's Disease

    Parkinson's disease is a neurological disorder that affects movement. Symptoms may include slowness, rigidity, tremor, and problems with balance and posture. The symptoms of Parkinson's result from the loss of dopamine-producing cells in the brain, but the cause of cell loss is not known. Medications and surgical treatments can relieve symptoms but do not cure the disease. More than a million people in the United States have Parkinson's disease.

    There are several excellent websites that provide information about Parkinson's disease and its treatment. See some of our favorites under resources.

    What is “young onset?”

    The average age at which Parkinson’s is diagnosed is 60. However, about 10-20% of those diagnosed with Parkinson's disease are under age 50, and about half of those are diagnosed before age 40. When the diagnosis is made early, it is referred to as "young onset" Parkinson's disease. So young onsets face different challenges than those diagnosed in their 60s and 70s.

    Why do we have a Young Onset Parkinson's Disease support group?

    • Connecting with other young people who are going through similar experiences can make you feel less alone. We believe that support groups provide the best forum for the individual and their caregiver to quickly gather information and to grow in the knowledge and understanding of their disease. In support groups you find wonderful people with compassion, courage, humor, and a desire to help each other.
    • To recognize and come to terms with your condition at a young age allows you to accept what has happened to you and you can take care of yourself, exercising, taking part in the daily activities you have always enjoyed, consulting a movement disorder specialist and participating with him or her in managing your disease. In other words, take charge of your life as much as possible.
    • Living with PD does not mean you should limit what you do. You should live life to the fullest, just as you would without PD. You do not need to advertise you have PD but, at the same time, don’t hide the fact. Freely admit you have the disease, it is nothing to be ashamed of. By being in a support group, you can tell your story which may help somebody else, or you might hear someone else’s story and gain some help from it. Through this give and take you gain strength and courage and learn new ways to cope. No matter how long you have had PD, attending support group meetings should be beneficial for you. The earlier you start, the greater the benefit.
    • We offer education about resources such as healthcare, insurance information, budgeting & planning, estate and special needs planning, support services for family & friends and veterans, case management services, mental health and employment and disability information.

    How can a support group serve you?

    • Learn about Parkinson’s disease treatment, news and research
    • Connect with other young people who understand the challenges first hand
    • Generate and share ideas for better self-care
    • Inspire one another to be strong and improve overall quality of life
    • Utilize your own experiences to help others

    About Our Meetings

    • Frequent presentations by medical experts and others with information helpful to you
    • General discussions among our members of mutual problems, concerns, and ways of living better with Parkinson’s. We stress confidentiality at all sessions to encourage greater openness.
    • Occasional “Breakout Sessions” for Care Partners to discuss among themselves issues in caring for a Person with Parkinson’s. When Care Partners meet separately, those with Parkinson’s talk about their own issues.
    • Exercise is a vital part of optimal living with Parkinson’s disease. To encourage it and to prevent complications from sitting too long, we have a short break mid-meeting during which we do easy exercises while seated.
    • We provide refreshments at our meetings, and encourage people to arrive early to meetings to get acquainted with one another and with the informational items available.

    2017 Dates

    • Location: Cleveland Clinic Administrative Campus, 25878 Science Park Drive, Building 3, Lower Level, Room 007 (AC3-LL-007), Beachwood, Ohio 44122
      • October 10, 2017
    • Location: Richard E. Jacobs Health Center, 33100 Cleveland Clinic Blvd, Room 103, Avon, Ohio 44011
      • November 14, 2017
      • December 12, 2017
    • Location: Strongsville Family Health Center, 16761 South Park Center, Community Room, Strongsville, OH 44136
      • June 14, 2017
      • September 14, 2017

    Email

    The YoungParkinsonsGroup@ccf.org email address offers interaction and networking for questions regarding the Young Onset Parkinson's Support Group through a dedicated e-mail address. Messages sent are retrieved by the YOPDSG staff who will return emails within 3-5 business days.

    This email address is for general Young Onset Parkinsons Support Group-related questions. We cannot field medical questions including personal information through this email address. If you have a medical question please use the secure online form.

    Call us

    YOPDSG voicemail is a dedicated phone line with a confidential voice mail box available as well for interested families. Messages left on this voice mail box are retrieved on a regular basis by the YOPDSG staff who will return calls within 3-5 business days. 216.444.8860


    Helpful Organizations

    Clinical Trials

    Depression

    Employment

    General Resources

    Genetics

    Medical Management

    • RxList
      Website: www.rxlist.com
    • U.S. Food and Drug Administration Center for Drug Evaluation and Research (CDER)
      General information line: 888.INFO.FDA (888.463.6332)
      Drug information line: 301.796.3400
      Website: www.fda.gov/AboutFDA/CentersOffices

    Memory

    Parenting

    PD Internet Community

    Related Links

    Relationships/Caregiving

    Sleep

    Surgical Intervention