Q&A: Movement Disorders

Parkinson's disease symptoms. Close up of tremor (shaking) hands of middle-aged woman patient with Parkinson's disease.

Treatment of movement disorders is based on a holistic approach. 

Natalie Diaz, MDMovement disorders are conditions that involve involuntary or abnormal movement, such as tremors. At Pacific Neuroscience Institute, a prestigious neurology group affiliated with Providence Little Company of Mary Medical Centers San Pedro and Torrance, we treat Parkinson’s disease as well as a range of other movement disorders, including essential tremor, dystonia and movement problems caused by stroke or other diseases. We asked Natalie Diaz, MD, a movement disorders specialist with Pacific Neuroscience Institute at Providence Little Company of Mary in Torrance, to explain advances in the treatment of movement disorders.

Are movement disorders difficult to diagnose? 

With movement disorders, everyone thinks of tremors. People come to medical attention faster when they notice tremors. But other types of symptoms can be nonspecific, such as muscle stiffness, slowing down, and memory or thinking problems. People can have those systems for years before they really start to impact a person’s life and they go to their doctor. 

How is a diagnosis made? 

We don’t have the 100% gold-standard test to diagnose any of these conditions. In most cases, the diagnosis is based on a comprehensive history and examination by a neurologist. But there are some tests that have come about in the past couple of years that can help. Besides using CT and MRI imaging, Providence Little Company of Mary also has something called a DaTscan (dopamine transporter scan). It’s a type of nuclear medicine scan that tries to determine how much dopamine a patient is producing in their brain. In Parkinson’s disease, brain dopamine levels are lower. We are one of the few institutions in the region that has special software that goes with the DaTscan. We get a printout of a computer assessment of dopamine. It’s an extra level of certainty. There are also newer ways to diagnose these conditions using a skin biopsy and, hopefully soon, a saliva test. 

Why do you urge patients to see a movement disorders specialist? 

We are neurologists who have extra training in Parkinson’s disease and movement disorders. Neurology knowledge is moving at such a fast pace that it’s impossible for a nonspecialist to keep up with the research and new medications coming out. In addition, most movement disorder clinics offer patient education and clinical trial opportunities that nonspecialized clinics cannot provide. 

Are there several options for the treatment of Parkinson’s disease? 

There are a lot of options. I let my patients know this is a very individual condition. Treatment depends on their main symptoms, age and other comorbid medical conditions. Our goal is to keep them moving, healthy and living their best life. We have more than 20 medications for Parkinson’s. They are non-curative, but they can be very helpful in managing the condition. We also have surgical options such as deep brain stimulation. 

What is your philosophy of care? 

It’s important for me to understand the patient and what’s important to them. Treatment of these long-term conditions is very holistic. We strive to keep them working, enjoying hobbies, enjoying family time and just living their best life. We always try to stress being positive, being hopeful, being active. People can still live productive, wonderful lives for many years with these conditions.

For more information on movement disorders, call 844-925-0942. 

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