Movement Disorders

Movement disorders are brain (neurological) conditions that affect the complex communication network between your brain, spinal cord (central nervous system), nerves and muscles. Glitches in this relay system can start from damage or malfunctions in your brain or other parts of your nervous system.

If this communication breakdown affects the part of your brain that controls movement, you may move more than usual (hyperkinetic). You may have spasms, jerking or shaking (tremors). Or you may find yourself moving slower or less than usual (hypokinetic). And, sometimes, it can be a mix of both, like having tremors and shuffling instead of walking.

Types of movement disorders

There are many kinds of movement disorders, like:

• Ataxia
• Atypical parkinsonism
• Chorea
• Dystonia
• Essential tremor
• Huntington’s disease
• Normal pressure hydrocephalus
• Multiple system atrophy
• Myoclonus
• Parkinson’s disease
• Progressive supranuclear palsy (PSP)
• Restless legs syndrome
• Tourette’s syndrome

Some can affect your whole body, while others may only cause problems with certain parts. Some affect your brain. Others, your nerves. And then there are ones that involve both. Each type can affect people differently. They can also look like other conditions. That’s why it’s important to work with healthcare providers experienced in evaluating and treating these conditions.

What to expect at your first visit

Your provider will want to hear your story when you come to your first appointment. Understanding what’s been happening with you is a big step in pinpointing your movement disorder — and planning the most personalized care. So, you’ll want to be prepared to answer a lot of questions, like:

• What kind of symptoms do you have?
• How long have you noticed these symptoms?
• How are these symptoms affecting your daily life?
• Have you been diagnosed with any health conditions?
• Have you already had any tests?
• Do you have any family history of neurological problems or movement disorders?

During this visit, your provider will do a physical exam to check your overall health. You can also expect to have a neurological exam that checks your reflexes and movement, among other things.

Testing for movement disorders

Your symptoms may also prompt your provider to order more tests to rule out other conditions and figure out what’s going on, like:

• Blood tests
• Electromyography (EMG)
• Electroencephalogram (EEG)
• Spinal tap (lumbar puncture)
• Nerve conduction study
• Neuropsychological testing

You may also have imaging tests like a CT scan or MRI so our team can look closely at your nerves, brain and spinal cord.

Meet Our Movement Disorders Team

Cleveland Clinic approaches treatment with a sense of teamwork. Providers from different specialties come together to plan your care — based on your needs. Your personalized movement disorders care team may have providers like:

• Neurologists
• Neurosurgeons
• Neurophysiologists
• Neuropsychologists
• Psychiatrists
• Radiologists
• Occupational therapists
• Physical therapists
• Speech-language pathologists

Movement disorders affect everything from the way you write to how you walk, talk and swallow. It depends on the kind of movement disorder you have and how badly it affects you. That’s why we craft your treatment plan based on your specific diagnosis and needs. We may manage your condition with:

Medications

Different medications can help movement disorders. Your provider may prescribe muscle relaxers or botulinum toxin injections. Or you may need medications that act like a brain chemical called dopamine or ones that make you less anxious. Your care team will go over what medications they feel will best help you manage your movement disorder.

Physical, occupational and speech therapy

Movement disorders can affect even the smallest everyday things, so your treatment plan may include physical, occupational or speech therapy. Our therapists can help you find better ways to move or do daily tasks like cooking or dressing. We can also help you improve eating and swallowing. You may learn how to use mobility aids like canes, walkers and wheelchairs. Our goal? To help you move safely and boost your independence.

Psychotherapy

Movement disorders often lead to things like depression and anxiety. Our team finds that psychotherapy, or talk therapy, can help you recognize and change unhealthy thoughts, behaviors and emotions. It can also give you an emotional game plan to move forward with daily life as you manage your condition. Your therapist can also recommend support groups for you and your family.

Surgery

For conditions with severe tremors like advanced Parkinson’s disease or dystonia, high-intensity focused ultrasound (HIFU), gamma knife surgery or deep brain stimulation (DBS) may help lessen these movements.

Living With Movement Disorders

When you have a movement disorder, you’ll work with your care team to find the best ways to manage it — and your daily life. You can expect to have regular checkups and testing so we can keep track of your progress and see if treatments need to be adjusted. It’s important to let your providers know if you notice changes in your symptoms.

Taking the Next Step

Finding out that you have a movement disorder isn’t easy. You finally have answers, but you also face a lifetime of managing your condition ahead of you. We know it can be hard to wrap your head around this kind of news. That’s why our movement disorder team focuses on taking care of you in every way you need. We guide and support you as you move forward with treatment — so you can enjoy the best possible life and live it to the fullest.