Diagnosis & Treatments
How We Diagnose Movement Disorders
To diagnose a movement disorder in your child, our neurology team will perform a thorough evaluation that includes a complete medical and family history. Diagnostic testing may include:
- genetic testing
- metabolic testing
- Brain MRI
- gait analysis
- EEG (electroencephalogram) to evaluate electrical activity of the brain
How We Treat Movement Disorders
When you bring your child to NewYork-Presbyterian for the treatment of a movement disorder, we perform a complete assessment of your child's health and function. Your child's team then puts together a personalized plan of care that may include one or more of the following non-surgical treatments, or surgery:
Non-Surgical Treatment
- Oral medications including Baclofen or direct muscular injections or Botox, or alcohol to to treat dystonia and spasticity
- Physical and occupational therapy to improve your child's flexibility, strength, mobility, and function, and the ability to perform activities of daily living.
- Orthotics, such as braces or supports, to limit unwanted motion in a joint, assist muscles that cannot be activated, improve balance, and create a more consistent walking pattern.
Surgery
When nonsurgical treatments are insufficient to help a child with a movement disorder, we may offer surgery, which has helped improve mobility, function, and quality of life for thousands of children. NewYork-Presbyterian is a leader in the use of minimally invasive surgery, which requires smaller incisions and is associated with a faster recovery than traditional surgery.
- Intrathecal Baclofen Pump, a spinal drug-delivery system to treat spasticity and dystonia. The surgeon places a small disc under skin in the abdomen which is connected to a thin tube placed into the spinal canal. This pump is programmed to deliver slow, steady infusions of medications that have limited side effects compared with the oral medications and can be precisely tailored to the needs and timing of each child. This procedure may also be reversed.
- Selective dorsal rhizotomy: This permanent surgery is highly effective in improving function, comfort and pain in children with severe spasticity in the legs, although some children with spasticity in both the arms and legs benefit. Some children may become more independently mobile with assistive devises. The surgeon operates on the nerve roots leading to sensory nerves in the legs. With a minimally invasive approach, our surgeons can determine which nerve roots are abnormal and can disconnect the ones causing the most damage and disability. This procedure is typically for children with relatively good strength in the legs but newer indications are being developed even for the most severely affected children.
- Deep brain stimulation: This surgery is only available for specific genetic conditions resulting in severe dystonia and involves the precise placement of tiny electrodes within the brain, attached to small battery packs in the chest wall, to better modulate the electrical signals leading to abnormal and disruptive movements of children’s bodies.
- Orthopedic surgery: A wide variety of orthopedic surgical options are available to treat movement disorders such as spasticity. Examples include tenotomy (surgery on a tendon), arthrodesis (fusion of a joint), osteotomy (removal of a portion of bone), tendon transfer or lengthening, complex hip reconstruction, foot realignment surgery, and crouch gait surgery. We work very closely with our colleagues in orthopedic surgery and physiatry to determine which procedures would benefit the child the most, and in which order any procedures should be triaged.