The neurologists and neurosurgeons at Torrance Memorial Medical Center offer expert care for all types of movement disorders and related symptoms. Our affiliation with the neurology and neurosurgery team at Cedars-Sinai — which is ranked among the best hospitals in the nation for neurology and neurosurgery care by U.S. News & World Report — means that our patients have access to some of the nation’s top doctors, the most promising clinical trials, and the latest and best treatments.
Led by Echo Tan, MD, a fellowship-trained movement disorder specialist in the Department of Neurology at Cedars-Sinai, the clinic offers expert consultation for a full range of movement disorders. Dr. Tan collaborates with each patient’s referring neurologist to develop a treatment plan that includes the latest therapies.
What are Movement Disorders?
Movement disorders are neurological conditions that cause increased abnormal movements, such as muscle spasms or flailing; slowed movement, such as slurred speech; or impaired movement, such as loss of balance.
Many conditions fall into the category of movement disorders, including Parkinson’s disease, tremors, restless leg syndrome, and Huntington’s disease. These conditions all have different causes — some of them unknown — but they are grouped together because they have a neurological mechanism behind them and their symptoms always include abnormal movement.
Types of Movement Disorders
Movement disorders can range from mild to severe and include:
Akathisia is a condition that makes you feel an uncontrollable urge to move. People often relieve the urge by swinging their legs, rocking back and forth, or pacing. Akathisia is a side-effect of antipsychotic medication.
Ataxia literally means lack of coordination. Patients with this condition lose control of their arms and legs and may be unable to balance, walk, or speak clearly. Ataxia can be caused by other medical conditions, including multiple sclerosis, tumors, stroke, and nerve damage. Ataxia can also be inherited genetically.
Chorea refers to involuntary movements, such as flailing and muscle contractions, that affect all different parts of the body. Chorea can cause someone to develop an abnormal gait and have trouble talking or swallowing.
Chorea is a symptom of Huntington’s disease, a genetic condition that is progressive, degenerative, and impacts other things besides movements, such as cognition and mood. However, Huntington's disease is not the only cause of chorea. It can also be caused by other conditions that are not inherited, such as rheumatic fever and certain autoimmune diseases.
Dystonia is a disorder that causes involuntary muscle contraction, which results either in repetitive, involuntary movements or getting stuck in certain positions. Dystonia can affect only one part of your body, one side of your body, or your entire body.
Dystonia can be caused by stroke, in which case it will usually just affect one side of your body. But dystonia can affect people who have never had strokes, and in these cases, the causes are still unknown.
Parkinson's disease is a degenerative nervous system disorder characterized by disordered movements, such as tremors, rigid muscles, and loss of automatic movements. These symptoms are caused by a lack of a neurotransmitter called dopamine. Because Parkinson’s disease is a progressive disorder, symptoms will start as minor — perhaps barely noticeable — and slowly worsen over time.
Parkinson’s disease is not fatal, but there can be serious complications, such as difficulty chewing and swallowing. In the most advanced stage of Parkinson’s, patients are unable to walk on their own and may need 24-hour care. There is no cure for Parkinson’s, but treatment is available to slow the progression of the disease and reduce symptoms.
In the early stages of Parkinson’s disease, symptoms may include:
- Tremor (often in your hands or fingers)
- Lack of facial expression
- Slurred speech or softer speech
- Arms no longer swing when walking
Parkinson’s disease does not progress the same way in every patient, but most people experience some of the following symptoms as the condition worsens:
- More severe tremors or shaking
- Slowed movement
- Rigid, painful muscles
- Shortened steps or shuffling gait
- Poor posture
- Impaired balance
- More significant changes in speech
- Changes in handwriting
- Loss of automatic movements (such as blinking)
Progressive Supranuclear Palsy (PSP)
PSP is an illness that has many of the same symptoms as Parkinson’s disease (which is also a movement disorder), but is a distinct condition. PSP is caused by damage to certain cells in the brain stem, but scientists still do not know how that damage occurs.
PSP impairs balance and can impair vision and focus by affecting the muscles around your eyes. Other symptoms include dementia, unusual emotional outbursts, depression, and tremors in the hands.
Tourette syndrome causes different “tics,” which could be movements or vocalizations that you feel compelled to make. If you have Tourette syndrome, you may be able to suppress your tics temporarily, but not for extended periods of time. Tourette syndrome is believed to be genetic, though a specific gene has not been identified.
A tremor could be a symptom of a condition previously mentioned, or it could exist on its own. A condition called essential tremor (ET) causes a noticeable tremor in a certain part of the body and is believed to be inherited.
Your physician will diagnose your movement disorder by assessing your symptoms and medical history and performing a neurological exam. If necessary, your physician may order blood tests or imaging studies.
Diagnosing movement disorders in their early stages can be more difficult because the symptoms are usually less severe. Your primary care provider may be able to diagnose a movement disorder, but you should get a second opinion from a neurologist who specializes in diagnosing movement disorders.
Cedars-Sinai’s Movement Disorders Program and Parkinson’s Disease Center are staffed by a specially trained team of neurologists who accurately diagnose Parkinson’s disease and other movement disorders and develop optimal treatment plans.
Treatment for a movement disorder will depend on the type of movement disorder you have, the stage of your disease, and your specific symptoms. Many movement disorders are not curable, but their symptoms can be reduced, and you can receive support to help you live with the condition.
Cedars-Sinai has a multidisciplinary team, which includes neurologists and neurosurgeons that specialize in movement disorders, physical therapists, occupational therapists, psychiatrists, and social workers. Depending on the stage of your disease, your treatment plan may include lifestyle changes, medication, or in some cases, surgery.
In addition to medical interventions that reduce symptoms, our specialists also offer physical therapies that improve motor function, and psychotherapies focused on providing the coping skills required to navigate life with a movement disorder.
Treatments offered by the Cedars-Sinai team include:
- Advanced medication therapy
- Botulinum toxin (Botox) injections
- Deep brain stimulation
- Focused ultrasound
- MRI-guided laser ablation
- Radiofrequency ablation
- Physical medicine and rehabilitation, which may include:
- Physical therapy
- Occupational therapy
- Behavioral therapy
- Speech therapy