SNI Blog

SNI Blog

How much tremor is too much?

Ryder P. Gwinn, MD

Tremor is a normal physiologic reaction to anxiety or stress, but it is not normal to have a tremor when performing typical daily activities.

People who develop a tremor while eating, drinking, writing or doing other common activities may have a movement disorder called Essential Tremor. This is actually the most common movement disorder, and can affect up to 4% of people over age 40. People who have this disorder can take medications to help minimize the tremor, but they don't often reduce the tremor by more than about half. Deep brain stimulation (DBS) is an excellent treatment option for people with severe tremor, and can nearly eliminate the tremor in many patients. Many patients aren't sure when their tremor is severe enough to warrant surgery, and much of our conversation in the office is to help answer this question.

There is no one answer that is right for everyone, but for me it has to do with how well someone is actually doing in their daily life:

New considerations given about when to refer for Deep Brain Stimulation

Peggy Shortt, MN, ARNP

Peggy Shortt, MN, ARNP
Manager, Swedish Deep Brain Stimulation Program

Every year in the fall, our Swedish DBS Team has a table in the exhibit area at the Hope Conference for Parkinson's Disease. It is a wonderful opportunity to meet people in the PD community, and spend time chatting with our other neuroscience colleagues from centers in the area.

I am always surprised by the numbers of people who come by and say, “I am not ready, my disease is not bad enough, I am too young, or I haven't had PD long enough”...

The Goal of DBS (Deep Brain Stimulation) Surgery

Peter C. Nora

I met with several patients this week to discuss their personal journey to making the decision to pursue DBS surgery. Not surprisingly, they were well educated about their disease and treatment options.

Each patient reminded me that there is a lot of information and misinformation about surgery for movement disorders.

The most important advice I can give any patient or family is...

Deciding to have Deep Brain Stimulation (DBS) for PD, ET, or dystonia

Peggy Shortt, MN, ARNP

Peggy Shortt, MN, ARNP
Manager, Swedish Deep Brain Stimulation Program

Choosing to undergo elective deep brain stimulation (DBS) surgery is a big deal.

I have walked through the process with hundreds of patients over the past 10 years and see many struggle with the choice to undergo brain surgery, as they seek to improve their quality of life. Many people have adapted to compensate for the movement disorder with creativity and determination.

In spite of this, after the best medical options have been exhausted, DBS is increasingly offered as a viable treatment option.

Keys to making the best decision for you are:

Vision Problems and Pituitary Tumors

Marc R. Mayberg

Nearly everyone notices vision problems, especially as you get older. In the great majority of cases, this is simply due to changes in the focusing capacity of the lens, and the solution is wearing glasses. However, it isn’t safe to assume that this is always the case. It’s important to have your eyes examined by a trained professional to determine whether something more serious is affecting the eye or the vision nerve. 

In the video below you’ll learn about something I commonly see in my practice – vision loss from a tumor of the pituitary gland that is putting pressure on the vision nerves. This type of vision loss typically reduces the peripheral vision to either side. This can be diagnosed by a test at the eye doctor called Visual Fields. As in this case, a relatively simple operation can reverse the vision problem before it becomes permanent. The key is early diagnosis. If you notice that your peripheral vision is affected, ask your eye doctor to check visual fields.

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SNI Research Aims to Expand Cerebral Palsy Therapy Options

Angeli Mayadev, MD

Angeli Mayadev, MD
Physical Medicine & Rehabilitation, Swedish Multiple Sclerosis Center

Before they learn to crawl or walk, about 10,000 babies every year in the United States will develop a condition that will change how they will do just that. Cerebral palsy (CP) is a neurological condition caused by a brain injury before birth, during delivery or before a child’s second birthday. An estimated 800,000 Americans live with CP.

The most common symptom in CP is spasticity, an increase in muscle tension that impairs proper movement. Abnormal postures or movements, weakness or loss of muscle control and rigidity are also part of the constellation of CP signs and symptoms. While physical therapy remains the cornerstone for treatment, new medications and therapies for CP are being developed to help improve and manage symptoms.

Currently, Swedish Neuroscience Institute is participating in a study to determine the safety and tolerability of one such medication. Dalfampridine (AMPYRA ®) is a medication currently used to help improve walking speed in multiple sclerosis (MS) patients. This phase I clinical trial aims to evaluate AMPYRA’s® safety, tolerability and its effect on sensorimotor function of adults with CP. The study will look at how single and multiple doses of the medication have on CP patients, including:

  • Hand strength
  • Manual dexterity
  • Walking speed
  • Gait

There is no cure for cerebral palsy. Therapies for CP ...

Swedish Contributes to New Treatment Option for Multiple Sclerosis

Pavle Repovic, MD, PhD

 On September 12, 2012, the Food and Drug Administration (FDA) approved teriflunomide for the treatment of multiple sclerosis (MS). Teriflunomide (AUBAGIO) is a once-daily pill for the treatment of relapsing forms of MS. Led by Dr. Lily Jung Henson, the Swedish Neuroscience Institute was among several clinical sites that tested the drug. Results of the research showed that teriflunomide can lessen MS disease activity. Specifically, it behaves similarly to injectable therapies by slowing MS relapse frequency, the rate of disability and MRI activity.

The safety profile, however, is more challenging than ....

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Top Authors

Karen Pabillon
Peggy Shortt, MN, ARNP

Peggy Shortt, MN, ARNP
Manager, Swedish Deep Brain Stimulation Program

John W Henson IV

John W Henson IV
Director, Neurology

Erin Kieper

Erin Kieper
Program Development Manager, Swedish Radiosurgery Center