Movement Disorders


Movement disorders are diseases that affect a person’s natural movements. This may include slowed or not enough movement (hypokinetic) or increased or too much movement (hyperkinetic).

There are a wide range of movement disorders. Examples of hypokinetic movement disorders include Parkinson's disease and Parkinsonism although the tremor aspect is too much movement in the resting state. Examples of hyperkinetic movement disorders include Dystonia, Chorea and Huntington's disease, Ataxia, Essential Tremor, and Restless Legs syndrome, to name a few.

Spasticity is more of a motility disorder in that there may not be enough movement such as after a stroke or consequence of Multiple Sclerosis but at the same time muscle tone is increased causing further restriction of normal movement. Some of these conditions are hereditary while in others, no genetic cause has been found as of yet. There may be an interplay of the environment with a genetic predisposition that causes many of these disorders to come to the surface. Genetics loads the gun but environment pulls the trigger.

The diagnosis of the type of most movement disorders is made clinically which means that the diagnosis is based on the symptoms you are experiencing and what is found on the examination. Occasionally certain imaging studies (such as CT or MRI) or blood studies, including genetic testing, can support a diagnosis although in even severe movement disorders, the scans and lab studies are usually normal since the cause is more of an electrical or chemical disturbance in the brain and not something that can be seen on a scan or detected in the blood. Treatment of movement disorders depends on the diagnosis.

Some of the more common diagnoses treated in our clinic are listed below:

Botulinum Toxin Treatment with Botulinum toxins type A (Botox, Dysport, Xeomin) or Botulinum toxin type B (Myobloc)

Dr. Hogan was the first Neurologist in Washington state to be trained to perform Botox injection therapy for Neurological disorders. He has been treating Dystonias with Botox since 1989 and has since expanded his expertise to use Botox or Myobloc Dysport (type A) to treat spasticity, hyperhydrosis (excessive sweating), migraine, and myofacial pain disorders. He now has the greatest experience and treats the largest number of patients with this form of treatment than any physician in the Northwest United States.

Deep Brain Stimulation for the Treatment of Parkinson's Disease

Working in cooperation with Dr. Peter Shin and the Fransican Medical System, Dr. Hogan and Sharon Jung ARNP work to diagnose candidates for this exciting new surgery. Deep Brain Stimulation works by electrically stimulating selected targets in the brain that control movement and muscle function. Two leads with tiny electrodes are surgically implanted in the brain and connected to a neurostimulator in the chest. The electrical stimulation is adjusted in our office to fit each patient's needs. South Puget Sound Neurology provides diagnosis, surgical monitoring , post operative medication adjustments and programming of the electrical implants.



Doctor and patient Photo