Management and Experimental Therapeutics
Dr. Jankovic helped pioneer the use of botulinum toxin to treat movement disorders including dystonia, spasmodic dysphonia, tremor, and tics. The toxin is a protein produced by the bacteria clostridium botulinum. When ingested orally the toxin can cause food poisoning, known as botulism, but when injected into the muscles, it blocks the chemical impulses from the nerve to the muscle, causing temporary local weakness, called chemodenervation.
The clinic collaborates with the Department of Neurosurgery to provide surgical options to patients who receive limited benefit from other therapies. Recent improvements in neuroimaging and microelectrode recordings have helped refine stereotactic surgery, such as pallidotomy and thalamotomy, and have made the procedure safer and more effective. Deep brain stimulation (DBS) is another option for patients with severe disabling tremor. In this procedure, the surgeon implants an electrode in the thalamus, the outside portion of which is connected to a stimulator, implanted under the skin in the upper chest. The stimulator generates electrical impulses which block the contralateral tremor. This procedure is similar to the thalamotomy except it does not cause a permanent lesion to the brain.
The Parkinson's Disease Center and Movement Disorders Clinic is continually involved in numerous clinical trials designed to develop new medications for movement disorders. Some of the drugs studied have been: pergolide, Sinemet CR®, Botox®, botulinum toxin type B (BOT B®), ropinirole, pramipexole, midodrine (Pro-Amatine®), entacapone, and others.
Further information on specific therapies may be found in the pages discussing: