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Areas of Specialization

Over the years we have developed a team approach to the management of Parkinson’s and Movement disorders, utilizing off-site specialists when needed. In addition to our neurologic services, our approach allows us to comprehensively address the spectrum of symptoms associated with these disorders.

Movement Disorders

Here are some of the conditions we routinely manage:

  • Alzheimer’s disease

  • Blepharospasm

  • Cervical dystonia

  • Chorea

  • Dementia

  • Drug-induced movement disorders/tardive dyskinesia

  • Dystonia

  • Dyskinesia

  • Gait disorders

  • Hemifacial spasm

  • Huntington's disease

  • Lewy Body dementia

  • Parkinson's disease

  • Parkinsonian syndromes

  • Progressive supranuclear palsy

  • Normal pressure hydrocephalus

  • Restless legs syndrome

  • Spasticity

  • Tic disorders

  • Tourette’s syndrome

  • Tremors

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Image by Derek Finch

Parkinson's Clinic

Parkinson’s is a common movement disorder, affecting over a million persons with the US at any time.Parkinson’s disease is the most common condition treated in our center and over half of our patients arereferred for management of this condition.

Our PD diagnostic or therapeutic procedures offered at our center include DBS programming, DaTscan re-interpretation, botulinum toxin injections for PD dystonia or drooling, SYN-ONE skin biopsy for PD diagnosis and PD clinical trials research. 

 

Deep Brain Stimulation

Our center established Michigan’s first functional neurosurgical program and performed the first DBS surgery in Michigan in 1998.  Together with Dr. Fredrick Junn, we have treated more patients than any other program in Michigan and remain Michigan’s most experienced functional neurosurgical program.  Dr. Trosch has lectured Nationally and Internationally on DBS programming.  We have recently added BrainLab Imaging guidance to our programming platform, improving our intraoperative guidance and postoperative programming targeting. 

 
Walk in the Park

Restless Leg Syndrome

Restless legs is a genetic disorder causing an urge to move the legs when inactive.  The diagnosis of this condition is based on the patient’s historical description of their symptoms.  The vast majority of patients achieve good control of their symptoms with oral medications. 

 

Botulinum Toxin Procedures

Botulinum toxin are FDA approved for the management of a variety of neurologic conditions, including
focal dystonia, spasticity, hemifacial spasms, and sialorrhea. Our center utilizes ultrasound guidance
with our intramuscular injections to provide consistent, accurate targeting with a lower risk of adverse effects.


Indications for Botulinum toxin Injections:
Cervical Dystonia
Hemifacial Spasm
Blepharospasm
Spasticity
Migraine
Sialorrhea/Drooling
Oromandibular dystonia

Drug and Syringe
 
Surgery

Normal Pressure Hydrocephalus

Normal pressure Hydrocephalus or NPH is an acquired disorder presenting with gait difficulty, bladder dysfunction and cognitive impairment.  It is managed with a surgical procedure, placing a ventriculoperitoneal (VP) shunt. Working with select neurosurgeons, our center uses a combination of clinical and imaging criteria to select appropriate patients for VP diversion shunt surgery.  

 

Tardive Dyskinesia

Treatment with antipsychotic or antiemetic medications can cause a group of permanent and socially disabling movement disorders known at tardive dyskinesia (TD).  Our center offers both in-office and telemedicine visits to diagnosis and treat TD.  We utilize the Clinician’s Tardive Inventory (CTI), an in-house scale developed in our center by Dr. Trosch for the diagnosis of tardive dyskinesia.  Dr. Trosch has lectured across the country on the topic of TD and is the recipient of a Telly Award for TD educational programming. 

Image by Gabrielle Rocha Rios