Movement disorders   

Have you tried Vitamin K2? In light of a recent publication: Tan et al., PMID 39466236

Does this recent meta-analysis influence your thinking? Yan et al., PMID 40099430

For example, if their tremor recurs over time or initial benefit is inadequate.

The controlled trial below demonstrated improvement in dysphagia among Parkinson's patients. Might this have greater potential for benefit than modifi...

In which intervals do you increase the dose and what is the maximum dose you usually try (before considering levodopa to be ineffective in the particu...

In light of the long-term follow-up of the LEAP study published in 2024 - Frequin et al., PMID 38644623

In light of commercially available SYNTap CSF testing.

Are such patients candidates for anti-amyloid therapy?

In light of the publication by Macías-García et al., PMID 39102249 on combined physiotherapy and cognitive behavioral therapy for functi...

In light of new findings on the efficacy of continuous subcutaneous levodopa-carbidopa infusion (Espay et al., PMID 38499015).

In light of the growing list of options with daxibotulinumtoxin. A receiving FDA approval in August 2023.

Does the approach differ if the tremor stems from essential tremor or Parkinson's disease?

The tremor fluctuates and can last for 45 minutes with the inability to talk, eat, or drink.

Particularly when ondansetron and taking it with food are not beneficial.

Are higher levels of exercise in patients with PD potentially even more beneficial to brain health?

In a patient who is already on a standing regimen of baclofen, tizanidine, trihexyphenidyl, clonidine, and diazepam and who is taking additional diaze...

If so, what is the recommended maximum dose of clozapine for PD patients? 

This applies to using EVD either in addition to or instead of a large volume lumbar puncture.

Which tests do you typically order?

How would you educate Parkinson's patients about the benefits of exercise based off of this study?

For example, patients with spasticity due to hypoxic or anoxic brain injury.

Do you charge for it? Do you bring them in to complete the paperwork? Or do you send them to PT for Functional Capacity Evaluation?

How do you treat medically refractory sleep related movement disorder in patients who has failed medical management with dopamine agonists, gabapentin...

Focused ultrasound or DBS?

Do EMG studies such as myoclonus or tremor studies change your management?

Is there a clinical scenario in which using the 10mg/100mg Carbidopa/Levodopa formulation is preferred to or more beneficial than using the more commo...

Especially forms of non-pharmacologic treatment, such as physical therapy or special devices.

When should we consider getting DaT scan in patient suspecting of Parkinsonism syndrome? 

We often use abdominal binders and compression stockings, in addition to hydration and midodrine/fludricortisone. However, are there more targeted the...

How do you manage botulinum toxin injections in a patient with cervical dystonia after getting implanted with DBS?

The most frequently taught cause of asterixis is hepatopathy and of course hepatic encephalopathy, and has other close associations (ie, uremia), I ha...

How do you manage freezing of gait in Parkinson disease when dopaminergic therapy worsens the freezing phenomenon?

Do you just see if the tremors are more associated with action versus static tremors? What are other clinical characteristics that can be helpful to c...

What testing do you typically proceed with?

Given the bleak prognosis in HD, how do you decide which patients will benefit from DBS to treat the chorea?

How do you manage ADHD in patients with Tourette syndrome in order to prevent exacerbating the tics such as with medications like Aderall?