Surgery for Movement Disorders

When tremor, stiffness, slowness, or involuntary movements are no longer controlled by medication, precise surgery can restore function. Start by finding your condition below.

Find your condition ↓
Conditions

Find your movement disorder

Surgery does not cure these conditions or stop them from progressing, but it can dramatically reduce the symptoms that medication no longer controls. Each page explains the condition and the surgical options that can help.

Parkinson's Disease
When the response to medication becomes unpredictable: deep brain stimulation, focused ultrasound, and lesioning.
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Essential Tremor
For a disabling hand tremor that no longer responds to medication: VIM deep brain stimulation and incisionless focused ultrasound.
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Dystonia
For abnormal postures and involuntary muscle contractions, including cervical dystonia: deep brain stimulation of the globus pallidus.
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Hemifacial Spasm
Involuntary twitching of one side of the face, usually from a blood vessel pressing on the facial nerve: microvascular decompression.
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How we target

Treating the motor circuit, guided by your own anatomy

Voluntary movement is governed by loops connecting the cortex, the basal ganglia, and the thalamus. In Parkinson's disease, tremor, and dystonia these motor circuits fire in abnormal rhythms that translate into the symptoms a patient feels. Surgery works by changing the activity of a precise node within these loops.

Increasingly, the target is refined using each patient's own white-matter connectivity, with both deterministic and probabilistic tractography, so that stimulation engages the intended pathway (for example, the tract that carries tremor) and limits side effects. The same map can guide either an adjustable stimulating electrode or a precise, often incisionless, lesion.

Map the circuit
High-resolution imaging and tractography reconstruct the motor pathways and the exact target in each patient.
Confirm and target
Stereotactic planning, often with intraoperative recording, reaches a millimeter-scale target through a small opening or with no incision at all.
Tune over time
With stimulation, settings are optimized over months alongside your neurologist to maximize benefit and minimize side effects.

Evaluation

How candidates are evaluated

Surgery is considered only after a movement-disorders neurologist has optimized medical therapy. A careful workup confirms the diagnosis, documents the response to medication (for Parkinson's, the response to levodopa strongly predicts surgical benefit), and assesses cognition. Neurology and neurosurgery then review the case together to select the procedure, the target, and the side that will give the most benefit. Surgery works best for idiopathic Parkinson's disease; some atypical forms of parkinsonism respond poorly and are screened for during evaluation.


About

Who wrote this site

Ahmet Fatih Atik, MD is a neurosurgeon focused on stereotactic and functional neurosurgery, including deep brain stimulation, focused-ultrasound and radiosurgical procedures, and stereotactic lesioning for movement disorders, with a research program in connectivity-guided targeting. This site is an independent educational resource and is not, by itself, medical advice.


Consultation

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