# Movement Disorders · Diagnosis and Treatment > Movement disorders unit: Parkinson's disease, essential tremor, dystonia, ataxia, chorea, Tourette syndrome, Huntington's disease, and functional movement disorders. Multidisciplinary approach with advanced treatments including DBS, HIFU, and botulinum toxin. URL: https://brainandspine-bcn.com/en/brain-surgery/movement-disorders/ Fuente: Brain & Spine Barcelona — https://brainandspine-bcn.com --- # Movement disorders Assessment, diagnosis, and treatment of neurological diseases that alter the form, speed, or control of movement. From Parkinson's disease and essential tremor to less common conditions such as Huntington's disease, Tourette syndrome, and the ataxias. Reviewed by Dr. Pedro Roldán Ramos , Neurosurgeon · functional surgery, DBS and HIFU · Last updated: 28 May 2026 ## When movement no longer responds as it should We use the term **movement disorders** to describe a broad group of neurological diseases that produce an alteration in the quantity, speed, or control of bodily movements. They can manifest as tremor, rigidity, slowness, involuntary movements, abnormal postures, or loss of balance. Moving a hand, smiling, or walking requires a precise choreography between the brain, the spinal cord, the peripheral nerves, and the muscles. When any part of that circuit fails, movement disorders emerge, with an impact that can range from the everyday (writing, eating, dressing) to the most fundamental (autonomy and quality of life). ### How they are classified - **Hypokinetic**, the amount of movement *decreases* or becomes slower. The main example is Parkinson's disease. - **Hyperkinetic**, involuntary movements appear *in excess*. This includes tremor, dystonia, tics, chorea, and many others. ## Symptoms of movement disorders Each disorder has its own clinical pattern. These are the most characteristic symptoms of the conditions we most frequently manage. ### Parkinson's disease - Resting tremor, usually asymmetric and starting in one hand - Slowness of movement (bradykinesia) and "cogwheel" rigidity - Short-stepped gait, reduced arm swing, and postural instability - Loss of smell, constipation, and REM sleep behaviour disorder as early signs ### Essential tremor - Action and postural tremor (when holding objects or writing), not resting tremor - Frequently affects both hands, the head, or the voice - Worsens with stress and caffeine; often improves temporarily with alcohol - Family history present in many cases ### Dystonia - Sustained involuntary muscle contractions causing abnormal or twisted postures - Focal forms: cervical dystonia (torticollis), blepharospasm, or writer's cramp - Repetitive movements triggered by specific activities - "Sensory trick" (geste antagoniste) that temporarily relieves the posture ### Other hyperkinetic disorders - **Chorea:** brief, irregular, and fluctuating involuntary movements - **Myoclonus:** sudden, brief, shock-like muscle jerks - **Tics (Tourette):** repeated movements or vocalisations, preceded by a premonitory urge - **Ataxia:** lack of coordination, unsteady gait, and difficulty with speech When to seek advice: with any tremor, rigidity, slowness, involuntary movement, or loss of balance that interferes with daily activities. An accurate and early diagnosis is key, as the course and treatment differ greatly between disorders. ## A specialised multidisciplinary team Managing movement disorders requires coordinating several specialities. At Brain & Spine Barcelona our dedicated team integrates neurology, functional neurosurgery, neuropsychology, neuroradiology, and rehabilitation, supported by specialist nursing staff who accompany the patient throughout the process. ### Precision diagnosis 3T MRI, functional neuroimaging (DaTSCAN, PET when indicated), neurophysiology, and cognitive assessment. The goal is to reach an exact diagnosis before planning any treatment. ### Personalised treatment Pharmacological adjustment, **botulinum toxin** injections, apomorphine therapy, or continuous infusion pumps, depending on the case. Non-surgical options are always first-line. ### Advanced functional surgery When medication is no longer sufficient, we offer [deep brain stimulation (DBS)](https://brainandspine-bcn.com/en/treatments/deep-brain-stimulation/) and [HIFU treatment](https://brainandspine-bcn.com/en/treatments/hifu/). Both techniques are performed by Dr. Pedro Roldán. ## Movement disorders we see From the most common to rare diseases, we evaluate and treat the full spectrum of movement disorders. For each we define a personalised therapeutic plan. Hyperkinetic ### Tremor Involuntary, rhythmic movements of the hands, head, voice, or other body parts. The most common is **essential tremor**, treated pharmacologically, or with HIFU or DBS when refractory. Hyperkinetic ### Dystonia Involuntary, sustained muscle contractions causing abnormal postures or twisting movements. Can be *focal* (affecting one area) or *generalised*. Treated with botulinum toxin and, in selected cases, DBS. Hypokinetic ### Parkinson's disease Slowly progressive neurodegenerative disorder characterised by resting tremor, rigidity, slowness (bradykinesia), and balance problems. [See full page →](https://brainandspine-bcn.com/en/brain-surgery/parkinsons-disease/) Hypokinetic ### Parkinsonism syndromes A group of diseases that produce symptoms similar to Parkinson's disease but with different underlying causes. Differential diagnosis is crucial because the course and treatment differ significantly. Hyperkinetic ### Ataxia Lack of coordination and clumsiness in balance, speech, or limb movements. Originates in the cerebellum or its connections. May be hereditary, sporadic, or secondary to other diseases. Hyperkinetic ### Myoclonus Sudden, brief, shock-like muscle jerks. May be physiological (on falling asleep) or pathological, linked to epilepsy, metabolic disorders, or other causes. Hyperkinetic ### Restless legs syndrome An uncomfortable sensation in the legs, especially when relaxing or lying down, that improves with movement. Seriously affects rest and quality of life. Mainly pharmacological treatment. Hyperkinetic ### Dyskinesia Repetitive, involuntary movements (grimacing, blinking, limb movements) usually associated with prolonged use of dopaminergic (Parkinson's disease) or neuroleptic medication. Hyperkinetic ### Gilles de la Tourette syndrome A neurological disorder beginning in childhood or adolescence characterised by repeated **motor and vocal tics**. In refractory cases, DBS has shown utility in selected patients. Hyperkinetic ### Chorea Brief, irregular, and unpredictable involuntary movements that flow from one body part to another. Can occur in Huntington's disease, Sydenham's chorea, or other causes. Hyperkinetic ### Athetosis A continuous flow of slow, fluid, writhing movements, generally in the hands and feet. Often associated with chorea (choreoathetosis) and can appear in cerebral palsy or basal ganglia lesions. Hyperkinetic ### Hemiballismus An intense variant of chorea with violent, large-amplitude movements of one arm and/or leg on one side of the body. Usually associated with subthalamic nucleus lesions (typically stroke). Neurodegenerative ### Huntington's disease A progressive hereditary disease with chorea, cognitive decline, and psychiatric symptoms. Requires a multidisciplinary approach and family genetic counselling. Atypical parkinsonism ### Multiple system atrophy (MSA) Progressive atypical parkinsonism with autonomic dysfunction (blood pressure, bladder function) and, in some cases, cerebellar signs. An important differential diagnosis with respect to idiopathic Parkinson's disease. Atypical parkinsonism ### Progressive supranuclear palsy (PSP) An uncommon neurodegenerative disorder that primarily affects balance, gait, and vertical eye movements, with a poorer response to levodopa than idiopathic Parkinson's disease. Hereditary ### Wilson's disease A hereditary disease caused by abnormal copper accumulation that can cause neurological and hepatic symptoms. Early diagnosis is essential because medical treatment is effective when started promptly. Functional ### Functional movement disorder Symptoms similar to other movement disorders but without detectable structural neurological disease. Requires careful diagnosis and a specific therapeutic approach combining neurology, psychology, and rehabilitation. ## Therapeutic options we offer The therapeutic plan is decided in committee after assessment. From the first pharmacological line to the most advanced functional neurosurgery techniques. ### Pharmacological treatment Levodopa, dopamine agonists, antiparkinsonian drugs, anticholinergics, antiepileptics, and other options depending on the clinical picture. Medication is adjusted on an individual basis at each visit. ### Botulinum toxin Outpatient injections for focal dystonias (cervical, blepharospasm, writer's cramp), spasticity, and focal tremor. Effect progresses over 3-4 months, with periodic repeat injections. ### Apomorphine and infusion pumps Subcutaneous therapies for advanced Parkinson's disease with complex motor fluctuations not controlled by oral medication. ### Deep brain stimulation (DBS) Implantation of brain electrodes connected to a subcutaneous pulse generator. Reversible, adjustable, and bilateral. Indicated for Parkinson's disease, tremor, dystonia, and other selected cases. [See DBS technique →](https://brainandspine-bcn.com/en/treatments/deep-brain-stimulation/) ### HIFU (focused ultrasound) Non-incisional brain surgery for essential tremor and tremor-dominant Parkinson's disease. A single session, no general anaesthesia, and same-day discharge. [See HIFU technique →](https://brainandspine-bcn.com/en/treatments/hifu/) ### Rehabilitation and physiotherapy An indispensable complementary programme. Neurological physiotherapy, speech therapy, occupational therapy, and, when appropriate, psychological support for the patient and family. ## Functional neurosurgery and movement disorder neurology The management of Parkinson's disease, tremor and movement disorders combines functional surgery (HIFU, DBS) with specialist movement disorder neurology assessment, both before and after the procedure. ### Dr. Pedro Roldán Ramos Neurosurgeon · Functional surgery, DBS and HIFU · Professor at the UB View profile ### Dr. Gabriel Salazar Tortolero Neurologist · Parkinson's disease, tremor and movement disorders View profile ## Where we treat movement disorders Surgical procedures are carried out in operating theatres equipped with the technology required for movement disorders. Your first consultation and follow-up can take place at any of our centres in Barcelona. ### Operating theatre ★ Operating theatre #### Hospital El Pilar C/ Balmes 271 · Barcelona ★ Operating theatre #### Barnaclínic+ Barcelona ### Consultation and follow-up Consultation #### Centro Médico Aribau Barcelona Consultation #### Clínica Olivé Gumà Barcelona ## What our patients say 5,0 Average rating on Doctoralia · testimonials anonymised with consent "I arrived with a glioma I had been told was inoperable. Here they reviewed it at the tumour board and offered me a plan. The surgery was a success. Four years on, I am well." "For years I had a cervical disc herniation, operated on by another team with no improvement. Minimally invasive surgery gave me back my mobility and took the pain away." "I travelled from outside Spain. The team reviewed my case before I came and gave me a clear plan. Caring people and impeccable technique." _**A multidisciplinary team by your side.** Neurosurgeons, neurologists and nursing staff working together on every case. [Meet the whole team →](https://brainandspine-bcn.com/en/team/)_