NeuroScience

Movement disorders are medical problems characterized by abnormal physical movements such as slowed movements and gait, or involuntary quick movements. They also include abnormalities of gait such as slowed gait, unsteady gait or poor balance. Examples of Movement Disorders are Parkinson’s Disease (PD), tremor, tics, myoclonus, chorea and dystonia.

Tremor – an oscillatory, shaking movement that usually involves the hands, but can also affect the head and legs. Some of the causes include essential tremor, Parkinson’s disease and enhanced physiological tremor due to medications

Dystonia – abnormal sustained postures and twisting movements. This can affect the neck (torticollis), eyelids (blepharospasm) and limbs, among other body parts

Tics – quick, jerk-like movements that cab be suppressed partially. Examples of these movements include eye blinking, facial grimacing, shoulder shrugging and body jerks. These are often called ‘habit-tics’, but are actually due to basal ganglia dysfunction

Hemifacial spasm – twitching of the eyelid and facial muscles on one side of the face. It is suggested that a blood vessel in the brain compresses the facial nerve, causing abnormal impulses down the nerve

What are the other treatments available for Movement Disorders?

Minimally invasive stereotactic brain surgery, including deep brain stimulation, is a new mode of therapy for advanced PD and other Movement Disorders such as intractable tremor and dystonia. In deep brain stimulation, electrodes are placed on the subthalamic nucleus of the brain and connected to a pacemaker placed on the chest wall

These surgical techniques are not a cure for these illnesses, but can further improve quality of life when medications cannot control the symptoms. Other types of Movement Disorders surgery include pallidotomy and thalamotomy

Not everyone can undergo this form of surgery. The neurologist and neurosurgeon will have to assess the individual for suitability.

Botulinum Toxin is derived from bacteria that causes food poisoning, and is one of the most potent toxins known to man. When injected in small quantities, it can be used to treat many Movements Disorders such as hemifacial spasm, blepharospasm, spasmodic torticollis, writer’s cramp and spasticity.

This has revolutionalised treatment, as many of these conditions may not be adequately treated with oral medications alone. The beneficial effect of bolutinum toxin injections generally lasts 4 months, after which repeat injections can be given.

You may consult your family doctor for a referral, or contact us directly at or email: neuroscience@meh.parkway.com.sg