Essential Tremor, Parkinson's and Movement Disorders

How We Diagnose Parkinson’s Disease and Movement Disorders

To diagnose your condition, we will review your symptoms and health history, conduct a physical exam and may perform additional tests, including:

• Blood or urine samples.Your health care provider may ask you to provide blood or urine samples to check for markers of neurological disorders and rule out other conditions.
• Electromyography (EMG). EMG measures the electrical impulses along your nerves and muscles to test how well your nerves and muscles work together.
• Imaging tests. Your health care provider may order imaging tests, such as magnetic resonance imaging (MRI) or computed tomography (CT), to help uncover neurological abnormalities and diagnose your movement disorder.
• Movement neurophysiological exam. We use a series of tests involving different types of stimulation — including visual, audible and electrical stimulation — to detect neurological abnormalities.
• Neuropsychological exam. This exam assesses cognitive skills, such as attention, executive functioning, memory, language and visuospatial processing.

 

Treatment for Parkinson’s Disease and Movement Disorders

Our multidisciplinary team of experts will consider your diagnosis, evaluation, health history and other factors to construct a personalized treatment plan to meet your unique needs, control your symptoms, maintain your independence and improve your quality of life. Our neurological specialists and neurosurgeons continue to pioneer new advances for treating Parkinson’s Disease to provide patients with access to the latest nonsurgical therapies for Parkinson’s disease and other movement disorders. Jersey Shore University Medical Center provides New Jersey’s most experienced robotic-assisted deep brain stimulation program. This is the only program in New Jersey with a team who has experience with robotic-assisted deep brain stimulation. Treatment options may include:

Nonsurgical Treatment

Neurosurgeons at Hackensack University Medical Center (HUMC) continue to pioneer new advances for treating Parkinson’s Disease and movement disorders, and HUMC is the only medical center in New Jersey using Focused Ultrasound (FUS), also known as high-intensity focused ultrasound (HIFU).

Medications

• Chemodenervation. This treatmentuses Botox injections to block nerve signals to your muscles, reducing the degree of abnormal movement.
• Dietary therapy. Our neurological specialists collaborate with registered dietitians to design a dietary plan to provide optimal nutrition while maximizing the effectiveness of your medications and managing other symptoms, such as difficulty swallowing.
• Other medications. Dopamine substitutes, anti-seizure, and blood pressure medications can also relieve symptoms of movement disorders.

Focused Ultrasound (FUS)

Hackensack University Medical Center (HUMC) is the only medical center in New Jersey using Focused Ultrasound (FUS), also known as high-intensity focused ultrasound (HIFU). FUS is a minimally invasive alternative to deep brain stimulation for patients with essential tremor and Parkinson’s disease tremor that has not
responded to medications.

Focused ultrasound uses acoustic energy, or
sound waves, to treat brain tissue that is the
source of the tremor. The outpatient procedure, which typically takes two hours, doesn’t require surgical incisions or anesthesia and many patients experience immediate and significant reduction in hand tremors, which can make activities of daily living challenging. Patients can return home the same day.

For more information on Focused Ultrasound or to schedule an appointment, email FUS@hmhn.org or call 551-996-5588.

Surgical Treatment

• Deep brain stimulation (DBS): DBS may be recommended for patients with symptoms that are not well controlled by medication. DBS works by implanting a small device in your brain that uses electrical stimulation to prevent nerve signals from causing abnormal movement.
• Stereotactic pallidotomy: This procedure uses stereotactic radiosurgery or radiofrequency ablation to create a small lesion in the part of the brain called the globus pallidus, which is responsible for movement control. Stereotactic pallidotomy may be an option for patients who cannot have DBS.
• Stereotactic thalamotomy: Used to treat essential tremor or tremor-dominant Parkinson’s disease, this procedure targets the part of the brain called the thalamus with radiofrequency generator or Gamma Knife stereotactic radiosurgery technology and creates lesions that stop or reduce tremors.

Supportive Treatment

We offer a full range of supportive services, including:

• Cognitive remediation. Cognitive remediation helps people with neurological conditions learn to manage challenges related to memory, reasoning, planning and other cognitive functions.
• Counseling. Our psychologists will provide counseling services to help you and your family cope with the emotional challenges of living with a movement disorder.
• Neuropsychology. Our neuropsychologists will help you understand and cope with problems with memory and other cognitive changes that can occur with movement disorders.
• Parkinson’s group exercise classes. A post-rehab group exercise class designed and administered by physical therapists and exercise specialists helps those with Parkinson’s improve their flexibility, balance and strength, enabling them to perform everyday activities with greater ease.
• Physical therapy and exercise. Your health care provider may recommend physical therapy or group exercise classes to improve flexibility, balance and strength.
• Speech therapy. Our speech-language pathologists follow the latest evidence-based treatment protocols to improve and preserve the voices of people with Parkinson’s disease.

Specialized Pediatric Movement Disorders Care and Treatment

Joseph M. Sanzari Children’s Hospital, JFK University Medical Center, and K. Hovnanian Children’s Hospital at Jersey Shore University Medical Center treat the full spectrum of neurological conditions in children, including movement disorders such as Chorea, Dystonia, Parkinson’s, Tourette syndrome, and Tics. Our pediatric neurology specialists work closely with families to manage their child’s neurological condition and improve their quality of life. Our board-certified neurologists have advanced, specialized training and years of experience in testing, diagnosis, treatment and follow-up care. Learn More About Children's Neurology

Clinical Trials and Research for Parkinson’s Disease and Movement Disorders

Our neuroscience experts provide patients with access to the latest clinical trials for Parkinson’s disease and movement disorders before they become widely available.

Hackensack University Medical Center is one of only a few U.S. medical centers participating in the RESTORE-1 Phase 2 clinical study, an investigational gene therapy trial for patients with Parkinson’s disease. Hooman Azmi, M.D., director of the Division of Movement Disorders at Hackensack University Medical Center’s Neuroscience Institute, performed the first surgery to place a one-time AADC gene into a specific part of the brain to stimulate dopamine production in October 2019. Learn more.