Movement Disorders Surgery
Movement disorders encompass a variety of neurological/ neurodegenerative conditions all of which create difficulty with proper movement. The most well-known of these diseases is Parkinson's disease, which is characterized by resting tremors, slowness of movement and muscle stiffness. Other common diseases which may be helped with surgery are tremor disorders (such as essential tremor) and dystonia (a disorder of muscle spasms and body twisting).
Surgery for movement disorders is a major area of focus at Weill Cornell Medical College. Our multi-disciplinary approach to the care of patients with movement disorders involves a team of physicians, nurses and therapists dedicated to the evaluation, treatment and follow-up of patients who are undergoing surgery. Our neurosurgeons help provide relief for patients who experience the tremor, rigidity, and slowness that are commonly associated with many different types of movement disorders. Surgery can also often alleviate some adverse effects of medication and can help reduce the need for medicine. Our panel of expert physicians will recommend the best approach for each individual patient to help alleviate debilitating symptoms.
At Weill Cornell, we use the most advanced imaging and guidance technologies to accurately target key brain structures using minimally-invasive, computer assisted techniques. For most patients, suppressing the abnormal electrical feedback in the brain with tiny surgically implanted electrodes can control sumptoms. Patients with Parkinson's disease, dyskinesias, essential tremor, and dystonia can be helped with a technique called deep brain stimulation (DBS), in which electrodes are precisely placed in the subthalamic nucleus, globus pallidus, or thalamus. Deep brain stimulation has allowed many patients to minimize their dependence on medications.
Using advanced imaging technology, our physicians are able to visualize the inner structures of the brain with unprecedented detail. The ability to see in three dimensions inside the brain helps the neurosurgeon precisely plan the entire operation before surgery to optimize targeting and reduce complications. Our surgeons choose the ideal target based upon the patient's disease and symptoms.
This procedure involves inserting a device that acts like a pacemaker for the brain. After extensive neurophysiological tests to determine the precise location, electrodes are surgically placed into specific points of a brain region called the thalamus. In a second surgery, wires are then run from these implanted electrodes into a battery pack in the patient's chest. A physician can regulate the device without any further need for surgery, and the stimulation provided to the brain minimizes the tremors that so plague patients with movement disorders.
Experts at the Weill Cornell Medical College are continuing to investigate innovative approaches to the treatment of movement disorders and are conducting pioneering research on gene therapy-based treatment for patients with Parkinson's disease. The Laboratory of Molecular Neurosurgery, which is the research arm of the movement disorders surgery program, is developing new gene-based approaches to other diseases, including Huntington's disease, obesity and major depression, using the same gene transfer technology already applied in our landmark human trial of gene therapy for Parkinson's disease.
Environment at Weill Cornell
Today, Weill Medical College of Cornell University cares for one of the world's largest populations of patients with Parkinson's disease, dystonia, tremors, ataxia, Tourette syndrome, myoclonus, and other movement disorders. We serve the population of the metropolitan New York region, but many patients are referred from all over the United States and other countries. Our surgical team works with neurologists at Weill Cornell who have a wealth of expertise in diagnosing and treating both common and rare movement disorders, and are on the forefront of both basic and clinical research geared towards developing novel therapies. These staff are based at the Movement Disorders Program located at NewYork-Presbyterian Hospital/Weill Cornell Medical Center's Department of Neurology. We also work closely with the Department of Rehabilitation Medicine, which has a particular interest in neurological movement disorders and spasticity. This provides our patients with comprehensive care to optimize their treatment both before and after surgery.