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Movement Disorders Program Uses Multiple Approaches for Parkinson's, Tremors

Dr. Jill M. Farmer closely examined the way her 81-year-old patient, Margaret Abramowitz, moved her arms.

“Touch your nose. Great. Move your arm. Perfect,” Dr. Farmer said.

Ms. Abramowitz has essential tremor, a movement disorder she has experienced for more than a decade.

On this recent visit, Dr. Farmer — a neurologist and movement disorders specialist — calibrated the pulse generator that sends Deep Brain Stimulation to Ms. Abramowitz's brain.

The patient, from Pennington, New Jersey, said the treatments have helped her tremendously.

“I had been on many medications, and, eventually, they all stopped working,” Ms. Abramowitz explained. “My doctor at the time said there was nothing else he could do. I am so happy I did not listen and instead found this treatment. Otherwise, I would be an invalid, I am sure.”

Deep Brain Stimulation is one of the tools Dr. Farmer uses to treat patients with movement disorders. She also provides medications and performs procedures, including botulinum toxin injections with electromyography guidance.

Dr. Farmer works at the Center for Neurologic Diseases at the Capital Institute for Neurosciences. The center provides a multidisciplinary approach to treating movement disorders, such as essential tremor, Parkinson's, dystonia, ataxia, atypical Parkinsonism and spasticity.

“We have many approaches to help our patients. Medications do not have to be the first, or only, approach,” Dr. Farmer said.

She explained that the center also provides services not regularly found in a community neurologist’s office, including rehabilitation, social services and speech and physical therapy, as well as access to sleep specialists and neurosurgeons.

Many of Dr. Farmer's patients have Parkinson's.

An article this year in Movement Disorders, a medical journal, found that an individually tailored, multidisciplinary team approach improved outcomes for Parkinson's patients.

“There is a new mentality of how to approach Parkinson's today,” Dr. Farmer said. “The idea of just using a medicine that has been around since 1967 should not be the first approach. We are diagnosing patients earlier, and we don't want them on only one medication for a long time. There are now many options available, so using the same approach with every patient is not fair to that patient.

“We used to think that Deep Brain Stimulation was a treatment of last resort for Parkinson's. Now we know that getting patients on Deep Brain Stimulation sooner can improve quality of life,” she said.

Parkinson’s is not just about movement and tremors. Patients can experience anxiety, depression, sleep disorders and cramping, as well as other symptoms.

“It’s valuable that patients find a center that will carefully and thoroughly review all their options and be able to provide a wealth of approaches and treatment,” Dr. Farmer said.

To schedule an appointment with Dr. Farmer call 609-537-7300.

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