Movement Disorders: Early Diagnosis and Treatment Eases Symptoms
Neurologist Sandra M. Kuniyoshi, MD, PhD, helps patients diagnose movement disorders early, benefiting their long-term quality of life
Getting older doesn't necessarily mean getting slower. In fact, getting slower—no matter what one's age—may be a sign of a treatable movement disorder.
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| Sandra Kuniyoshi, MD, PhD |
"The most important thing the public needs to know about movement disorders is that there are many options available for treatment," said Sandra M. Kuniyoshi, MD, PhD, a board-certified neurologist and movement disorder specialist on staff at John C. Lincoln North Mountain Hospital.
"Many people experience a slowing down of the body or a slight tremor in the arms, and they attribute such symptoms to old age."
While it's widely believed that such symptoms can’t be helped, Dr. Kuniyoshi stressed the need for patients to request neurological evaluation as soon as they experience tremors or lost mobility.
The earlier movement disorders are diagnosed and treated, the greater the possibility to restore motor abilities and thinking capability. Early diagnosis also allows patients to begin accessing support programs that educate them and their loved ones in the management of the disease.
Therapies Are Evolving Dramatically
Movement disorders, including Parkinson's disease and Tourette's syndrome, are neurological conditions that affect speed, quality and ease of movement. Symptoms can appear in the form of spasms, tremors, stiffness in the limbs and torso, slowed mobility, poor coordination, excessive and involuntary movement, impaired voluntary movement and poor balance.
"All those normal activities that people take for granted—getting out of a chair, getting out of a car—become very difficult for someone living with an untreated movement disorder," said Dr. Kuniyoshi.
Before the advancement of surgical techniques and medicines, patients with movement disorders might have expected to live with progressive degeneration and pain or experience constant drowsiness because of heavy medication.
However, more recent medications have caused dramatic improvements in the lives of people with Parkinson's. The cure for Parkinson's remains to be found, but the efficacy of medications can return patients to a normal quality of life.
Custom-Tailored Treatment
Because of the individual nature of each case, movement disorder programs are custom-tailored for each patient.
Patients with slight tremors can take medications as needed and receive coaching in techniques to prevent injuries.
"It’s a proactive approach," said Dr. Kuniyoshi. "We set the safety net down before there is a fall and a broken hip."
Botox injections may make most people think of cosmetic treatments, but physicians have used injections of botulinum toxin for almost 20 years to relax muscle spasms. First used to treat eyelid spasms and crossed eyes, Botox later was used for dystonia, which is caused by prolonged muscle contractions resulting in twisted movements or abnormal posture.
Surgical intervention may work best for progressed cases or those who experience significant side effects from medications, such as alternations between rigidity and excessive movement.
Deep brain stimulation, or DBS, uses an electrode implanted in a specific area of the brain to block abnormal neuron activity with electrical impulses. The DBS electrode is similar to a cardiac pacemaker and can be adjusted without further surgery as a patient’s condition changes over time.
"We want to get patients to where they are leading as normal a life as possible, with restored mobility and balance. When you are able to exercise, eat well and take care of yourself, you are going to have your symptoms under control much more quickly," said Dr. Kuniyoshi.
Small Changes Can Be Big Clues
When is it time to schedule a neurological evaluation?
"If a particular muscle spasm or tremor is affecting your life, if it's embarrassing you, it's a good time to be evaluated by a movement disorder specialist," said Dr. Kuniyoshi.
In fact, it's never too early to be concerned about loss of mobility.
Family members are usually the first to notice a loved one's altered movement patterns. With married couples, Dr. Kuniyoshi pointed out that one spouse usually moves faster than the other.
"During an evaluation, I often ask, 'Who gets ready faster in the morning?' This will usually reveal how much of a change there has been in a person’s routine," explained Dr. Kuniyoshi.
Finding True Fulfillment
One of Dr. Kuniyoshi's favorite success stories is the case of a 40-year-old male patient who expected to lose his job and move into an assisted living facility because of the severity of his symptoms. With a DBS implant, the patient was able to return to the work force, secure his own apartment and live an independent life.
Such successes inspire Dr. Kuniyoshi onward in her dedication to help those with movement disorders.
As treatments for movement disorders continue to evolve, Dr. Kuniyoshi finds true fulfillment in helping patients return to normal, active lifestyles.
Dr. Kuniyoshi said John C. Lincoln is an excellent match for her devotion to patients' well-being. "I'm impressed with John C. Lincoln's quality of people and proud of our focus on patient-oriented health care."