Pediatrics

Spasticity and Dystonia

NewYork-Presbyterian is home to the best pediatric neurology & neurosurgery program in New York

Pediatric movement disorders, such as spasticity and dystonia, are conditions that affect the speed, fluidity, coordination, and ease of movement in children. Movement disorders have a wide range of causes and symptoms that can worsen over time, affecting a child’s normal development and quality of life.

The NewYork-Presbyterian Pediatric Neurology & Neurosurgery program, operating across NewYork-Presbyterian Morgan Stanley Children’s Hospital and NewYork-Presbyterian Komansky Children’s Hospital, offers advanced diagnosis and treatment for the full spectrum of movement disorders in children and adolescents. Our world-class physicians diagnose and treat movement disorders resulting from cerebral palsy, spinal cord injuries, dystonia, traumatic brain injury, stroke, tumors, and other conditions.

Harnessing the breadth of expertise and vast resources across NewYork-Presbyterian, we customize a plan of care to give your child the best chance for a healthy and active life.

About Our Program

At NewYork-Presbyterian, our pediatric neurologists and neurosurgeons have extensive experience working with these difficult-to-diagnose conditions in children, and are actively developing and refining new treatments and procedures. Our patients come to us from across the country and around the world to seek the most advanced, safest, and proven treatments that enable children of all ages to reach their fullest potential and live their best lives.

Our pediatric neurology and neurosurgery team has clinical expertise across the entire spectrum of conditions that cause movement disorders, such as cerebral palsy, dystonia, traumatic brain injury, stroke, tumors, and similar conditions. These specialists take a comprehensive approach to diagnosis and treatment, working in multidisciplinary teams with specialists in neuroradiology and neuropsychology, orthopedic surgery, speech-language pathology and physical medicine and rehabilitation.

As part of a world-class medical center, we have the ability to centralize care for our patients and connect our patients to providers in more than 100 specialties and subspecialties. When the time comes, we can provide the support patients and their families need to ensure a smooth transition from pediatric to adult care.

What We Treat

NewYork-Presbyterian provides comprehensive care for children with movement disorders resulting from cerebral palsy, spinal cord injuries, dystonia, traumatic brain injury, stroke, tumors and other conditions. We treat the full spectrum of movement disorders, including:

Spasticity - a condition in which there is an abnormal increase in muscle tone or stiffness that interferes with movement, speech, and can be associated with discomfort or pain.
Tourette’s Syndrome and tics–involuntary, rapid and repetitive stereotyped movements and sounds
Tremor – involuntary, rhythmic muscle contraction leading to shaking movements in the body
Dystonia –a group of disorders characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both.
Ataxia – a disorder that involves unsteady posture, impaired coordination, often with poor balance and falling
Restless legs syndrome – a strong urge to move the legs, often during the onset of sleep
Myoclonus – involuntary rapid jerking or twitching of muscles or muscle groups

At NewYork-Presbyterian, children with movement disorders are treated by various sub-specialists, depending on the specific disorder. For instance:

Tics are treated by child neurologists
Movement disorders secondary to cerebral palsy (such as spasticity and dystonia) are treated by physical medicine specialists
Primary movement disorders (such as tremor, myoclonus, genetic spasticity or dystonia) are treated by pediatric movement disorder specialists

Our Approach to Care

At NewYork-Presbyterian, we take a fully integrated approach to the treatment of movement disorders in children at every stage, from infancy to childhood and adolescence, and the transition into adulthood.

Holistic and Comprehensive Care

At NewYork-Presbyterian, we recognize that every patient with a movement disorder has a unique combination of symptoms, circumstances and needs. Our pediatric neurologists and neurosurgeons take a holistic approach to care that considers the entire patient, including his or her physical, emotional and social factors. We strive to partner with patients and their parents in shared decision-making, empowering them with knowledge, support, and the most effective treatment options to address symptoms and improve quality of life.

Multidisciplinary Team Approach

At NewYork-Presbyterian, our pediatric neurologists and neurosurgeons collaborate in multidisciplinary teams with physical medicine and rehabilitation specialists, pediatric orthopedic surgeons, physical and occupational therapists, urologists, nurses and nurse practitioners, orthotists, and child life specialists, to examine a child’s movement disorder from multiple perspectives. Our goal is to identify the root cause of what is limiting the child’s movement and develop an appropriate treatment plan. Our first line of treatment is always non-surgical — our collaborative approach means that we’ll always exhaust all non-invasive options before we discuss surgical intervention.

Continuity of Care Through the Lifespan of the Child

There is a growing recognition that pediatric patients with chronic ailments need to receive continuous care by experienced and familiar surgeons as they age beyond their childhood years. At NewYork-Presbyterian, the pediatric neurology and neurosurgery team takes a multidisciplinary approach that focuses on the whole child and offers them the best opportunity to enjoy a normal transition from child to adult.

Children who have a lifelong need for specialized care, such as those with movement disorders, are embraced by our care teams. Our pediatric neurologists and neurosurgeons understand the continuous needs of their patients regardless of age and are vested in making certain that the transition from child to adult is simplified by not needing to change care teams. Our teams work with children through their adolescence, teen years and adulthood to help them understand their responsibility for their health and achieve their personal goals at every stage. When it is time, we help our patients seamlessly transition to one of our adult neurologists in the NewYork-Presbyterian Neurology program.

Why Choose Us

Access to World-Class Specialists

Your child's healthcare team has access to all of the various pediatric medical and surgical subspecialists who practice at NewYork-Presbyterian, ensuring that all of your child's medical needs can be addressed.

Strength in Collaboration

NewYork-Presbyterian’s pediatric neurologists and neurosurgeons are internationally recognized for the diagnosis and treatment of a wide range of neurological diseases and disorders in children. As physicians affiliated with dedicated children’s hospitals, they collaborate with pediatric specialists in every field of medicine and surgery as needed, including neuroradiologists, anesthesiologists, neuropathology, nurses, child life advocates and social workers specially trained to work with children. Their knowledge and clinical expertise across the entire spectrum of pediatric disorders of the brain and spine, coupled with a multidisciplinary team approach, enables them to develop expertise in very rare movement disorders and other conditions such as gene therapy, prenatal surgery, cerebrovascular diseases, and craniovertebral junction abnormalities.

Innovators of The Latest Therapies for Movement Disorders

Recent breakthroughs in understanding and treatment, including new medications and advanced surgical techniques, have led to more successful treatment of a wide range of pediatric movement disorders. At NewYork-Presbyterian, our clinicians are at the forefront of innovation in the treatment of movement disorders. We offer a full range of treatment options, including Botox injections and baclofen pump therapy, physical and occupational therapy, orthotics, and neurosurgical and orthopedic surgical treatments. We perform a multidisciplinary team assessment to determine the most effective therapy or combination of treatments for your child.

Advanced Surgical Techniques and Technologies

Our pediatric neurosurgeons are highly experienced in advanced surgical techniques to treat movement disorders:

Surgery with precision: Our pediatric neurosurgeons use the latest mapping and monitoring techniques to plan surgery to ensure the best outcomes while minimizing risk.
Microsurgery: Our pediatric neurosurgeons use microsurgery procedures that involve the use of a high-powered operating microscope and specialized instruments to operate on small or delicate structures in the brain and spine. These microsurgical techniques enable our neurosurgeons to navigate with tremendous precision around the finest nerve endings and blood vessels to repair or remove a brain abnormality. Microsurgery has ultimately allowed our neurosurgeons to perform minimally invasive procedures, which offer patients smaller incisions, fewer complications, and faster recoveries.
Minimally invasive surgery: Our pediatric neurosurgeons are able to utilize minimally invasive approaches to surgery in most of our pediatric patients, resulting in smaller incisions, less pain after surgery, less scarring, and a faster recovery. Minimally invasive operations allow children to recover faster with less pain after surgery, allowing them to begin the process of retraining their relaxed muscles with physical therapy and rehabilitation at an earlier stage.

Unique Neurology and Neurosurgery Specialty Centers

Across NewYork-Presbyterian, our world-class neurology and neurosurgery centers offer the most advanced care to children of all ages:

The NeuroMotor Disorders Program at the NewYork-Presbyterian & Weill Cornell Medicine Pediatric Brain and Spine Center and NewYork-Presbyterian/Columbia University Irving Medical Center brings together a multidisciplinary team of specialists from two Ivy League institutions who have been trained to diagnose and treat a wide range of movement disorders in children and adolescents.
The Center for Movement Disorders at NewYork-Presbyterian/Columbia University Irving Medical Center provides advanced neurosurgical treatments for children and adults with severe movement disorders when these conditions have resisted other forms of treatment. Our center is among the leaders in performing surgeries such as deep brain stimulation (DBS) and minimally invasive selective dorsal rhizotomy.
The Movement Disorders Service at the NewYork-Presbyterian & Weill Cornell Medicine Brain and Spine Center offers advanced treatment options for individuals affected by movement disorders, including Parkinson’s disease, dystonia, essential tremor, ataxia, Tourette’s syndrome, myoclonus, and related conditions.

Seamless Access to Resources and Support Services

At NewYork-Presbyterian, patients and families have seamless access our vast resources, including on-staff neuropsychologists who offer testing and treatments for emotional and cognitive issues that may occur after a brain disorder. We also have a Parent-to-Parent program that can connect you personally with a parent whose child has been treated for the condition your child has.

Pioneers in the Field

Our pediatric neurologists and neurosurgeons are actively involved in research to improve treatments for movement disorders in children of all ages, from newborns to young adults. We are committed to continue pursuing progress in the labs and at the bedside to achieve the best possible outcomes and quality of life for our patients.