Understanding Movement Disorders: More Than Just the Shakes

A change in the way you move—a new tremor in your hand, a feeling of stiffness or movements you cannot control—can be unsettling. These symptoms may be signs of a movement disorder such as Parkinson’s disease or Essential Tremor (ET), neurological conditions that affect your body’s ability to produce smooth, purposeful movement.

While many people associate these conditions with shaking, movement disorders encompass a wide range of symptoms that can have profound impacts on daily living, say specialists with Baptist Health Miami Neuroscience Institute. And new, advanced treatments are available that can improve quality of life for patients with movement disorders, they add.

What Are Movement Disorders?

“Movement disorders are conditions that affect how your body moves—causing too much movement, too little movement or movements you can’t control,” explains Diego Torres-Russotto, M.D., Chair of Neurology and the Distinguished Endowed Chair in Neurology at Baptist Health Miami Neuroscience Institute, and director of the Florida International University/Baptist Health Neurology Residency Program. “These issues arise from disruptions in the deep brain circuits responsible for controlling motor function.”

Movement disorders are more common than many people realize. Approximately 1 in 4 people will endure a movement disorder in their lifetime. Dr. Torres-Russotto notes that Parkinson’s disease affects approximately 1 percent of individuals over age 60, while essential tremor, an even more prevalent condition, may impact up to 5 percent of people over 65. Restless leg syndrome and Tics and Tourette Syndrome have a 3-5 percent prevalence. Other disorders, such as dystonia and ataxia, are less common but can significantly affect those who have them.

Common Types of Movement Disorders

There are hundreds of movement disorders, according to Dr. Torres-Russotto, each with distinct characteristics. Four of the most common types of movement disorders are:

1. Parkinson’s Disease

Parkinson’s disease is known for causing slowness of movement, stiffness, a tremor that occurs at rest and problems with balance. “People may also notice a softer voice, smaller handwriting or reduced facial expression,” says Dr. Torres-Russotto. These subtle changes are often early indicators of the condition.

2. Essential Tremor (ET)

This disorder is characterized by shaking that is most apparent when the hands are in use. Simple actions like drinking from a cup, writing or using a fork can become challenging.

3. Dystonia

Dystonia involves involuntary muscle contractions that cause a body part to twist or pull into an abnormal position. This can manifest as the neck turning to one side, uncontrollable eye squeezing or cramping in the hand during specific tasks.

4. Ataxia

Individuals with ataxia experience problems with coordination and balance, so their movements may appear clumsy, unsteady or “wobbly.”

Diagnosing Movement Disorders

A precise diagnosis is critical for developing an effective treatment plan. The process relies heavily on clinical expertise, as there is no single test for most movement disorders.

“A neurologist—ideally a movement-disorder specialist—usually makes the diagnosis,” Dr. Torres-Russotto says. The diagnostic process typically involves:

• A detailed medical history: This includes discussing symptoms, when they began, current medications and family health history.
• A careful movement examination: The specialist will observe walking, posture, coordination, muscle tone and tasks like writing.
• Imaging studies: An MRI or CT scan may be used to examine the brain’s structure and rule out other causes.
• Specialized testing: In some cases, tests like a DaTscan for parkinsonism or genetic testing can help clarify a diagnosis.

Dr. Torres-Russotto emphasizes that the expert clinical exam is the most crucial component of the diagnostic process.

Advanced Treatment Options

Once a diagnosis is made, a variety of treatments can help manage symptoms and improve function. Nestor Beltre, M.D., a neurologist and movement disorders specialist with Miami Neuroscience Institute, notes that therapies are tailored to each person’s specific condition and needs.

For conditions involving overactive muscles, such as dystonia, injections of botulinum toxin—the active ingredient in Botox and other neuromodulators—can be highly effective, according to Dr. Beltre. This treatment works by relaxing targeted muscles.

“Botulinum toxin injections cause relaxation and decreased firing of these muscles, which provides significant relief for patients,” he explains. To ensure accuracy, he uses advanced techniques. “By using ultrasound to guide placement of botulinum toxin, I can target the specific muscle causing symptoms while avoiding side effects of unwanted weakness.”

The procedure is performed in the clinic and typically takes just 15 to 30 minutes. Dr. Beltre notes that most patients see improvement within a week and the benefits last for about 90 days, at which point the treatment is repeated.

Advanced Surgical Procedures

For certain movement disorders, more advanced therapies may be recommended. These can include Deep Brain Stimulation (DBS) and focused ultrasound.

• Deep Brain Stimulation (DBS): This procedure involves implanting tiny electrodes into specific brain regions that control movement. The electrodes deliver gentle electrical pulses to regulate abnormal brain signals. DBS is used to treat Parkinson’s disease, essential tremor and dystonia. Key benefits are that it is adjustable to the patient’s symptoms and is completely reversible.
• Focused Ultrasound: This is an incisionless surgical option for certain types of tremor. It uses MRI guidance to focus sound waves on a precise point in the brain to interrupt the circuits causing the tremor.

Dr. Beltre adds that research on treating movement disorders is constantly advancing. “Research continues in areas such as long-acting botulinum toxins, focused ultrasound for tremor, advanced deep brain stimulation technologies and non-invasive neuromodulation,” he says.

The Importance of Early Evaluation

For anyone experiencing new or worsening symptoms, seeking a professional evaluation is essential. Early and accurate diagnosis allows for the timely implementation of therapies that can manage symptoms and prevent disability.

“If you or a loved one notice new tremors, stiffness or changes in movement or balance, it’s important to see a healthcare professional early—many movement disorders are very treatable, especially when addressed sooner rather than later,” says Dr. Torres-Russotto.

By consulting with a movement disorder specialist, patients gain access to comprehensive, multidisciplinary care that combines advanced diagnostic tools with personalized, evidence-based treatment plans. This proactive approach is key to improving function, maintaining independence, and enhancing the overall quality of life for individuals living with movement disorders, Dr. Torres-Russotto says.

Click here to learn more about the treatment of movement disorders at Baptist Health Miami Neuroscience Institute.