Dr. Nicholas Brandmeir

About 8 million people in the US suffer from one of two movement disorders, essential tremor and Parkinson’s disease, with essential tremor being the more prevalent but lesser known condition. These neurological disorders may cause a person to experience tremors (shaking) in different parts of the body accompanied by emotional difficulties from losing control of one’s bodily movements.

Deep brain stimulation can help ease symptoms of movement disorders and decrease the amount of medicine needed to treat these conditions. WVU Medicine neurosurgeon Nicholas Brandmeir, MD, an expert on movement disorders, provides you with information about these neurological conditions and the benefits of deep brain stimulation.

Parkinson’s disease
This is a progressive disease that causes degeneration of different areas of the brain, and it may start gradually with a small tremor in one hand, difficulty with facial expressions, stiffness in the body, or slowing of movement. Patients with Parkinson’s disease do not always develop a tremor. As the disease progresses, it’s more difficult to initiate movement, so patients have a hard time walking, standing from a chair, and even smiling. Patients with tremors often develop shaking that is worse when the body is still, and the condition improves when the body is in motion.

Essential tremor
This is a condition that causes the limbs and trunk (torso) to shake during daily activities, like eating, drinking, or writing. It may also affect the head and voice. Essential tremor is almost always worse when the affected part of the body is in motion than when it’s at rest. Often, it starts in youth or during middle age and progresses with age. Essential tremor often runs in families, and it’s common for one or more relatives to have this condition.

Diagnosis
The symptoms of a movement disorder usually begin with either a tremor or with difficulty controlling movements. Sometimes, the changes can be very subtle, like difficulty changing your facial expression to match your feelings, trouble walking through doors, or struggling while drinking from a cup without a lid. If you suspect that you or a family member may have a movement disorder, your doctor can make the diagnosis based on the history of the symptoms and what the movement difficulty/tremor looks like. Most of the time, a brain scan (MRI/CT) is needed to diagnose the condition. 

Treatment
Although there is currently no cure for movement disorders, most patients find significant relief with modern treatments, including medication, surgery, injections, physical therapy, and implantable devices. The first treatment approach for movement disorders is often medication and physical therapy. Eventually, many patients will either receive little benefit from their medication or experience side effects. In these cases, it may be time to consider deep brain stimulation.

Deep brain stimulation
This procedure is performed with a small incision to implant electrodes in certain areas of the brain to control abnormal impulses that cause movement disorders. The level of stimulation to the brain is regulated with a small device similar to a pacemaker that is placed under the skin of the upper chest area. Deep brain stimulation has been available in the US for more than 20 years and is considered a standard of care for both Parkinson’s disease and essential tremor. The procedure does not damage brain tissue, and patients stay in the hospital at least a day or longer. Studies have shown that deep brain stimulation is superior to medication alone for the treatment of movement disorders.

WVU Medicine movement disorders team
Our comprehensive movement disorders team includes neurologists, neurosurgeons, physical therapists, neuropsychologists, nurse practitioners, and more. Based on each patient’s individual diagnosis, we refer to the appropriate provider. With a wide range of expertise in delivering every mode of advanced treatment, our team enables patients to regain optimal motor control of their bodies and improve their quality of life.

The WVU Medicine movement disorders team includes:

Are you concerned that you or someone you know is suffering from a movement disorder? Make an appointment: 855-WVU-CARE.