Comprehensive Care Centre for Movement disorders (CCCMD)

INTRODUCTION

“Movement Disorders” are a group of neurological ailments manifesting either as “paucity” of movements (slowness of movements, often associated with stiffness of muscles and loss of balance – also called “Parkinsonism”) or unwanted excess of movements without the individual’s control (Involuntary movements). Movement disorders are not uncommon; “Parkinson’s disease” is one of the most widely known diseases which cause a movement disorder. Movement disorders generally result from abnormal functioning of “basal ganglia” - which are structures located deep within the brain. Stroke or other neurological diseases which cause weakness of muscles or ‘paralysis’, are not classified as ‘movement disorders’ though they also impair movements.

The Movement Disorders Section of the Neurology Department of SCTIMST started its functioning in July 1996. The Comprehensive Care Centre for Movement Disorders (CCCMD) at SCTIMST was established in 1998 in collaboration with the Department of Neurosurgery and is one of the first of its kind in India. The aim of the Centre is to provide the most advanced forms of medical and surgical treatment and ancillary services to patients afflicted with various movement disorders. The centre also trains post-graduate students in Neurology in the diagnosis and treatment of movement disorders, offers post-doctoral fellowship courses and PhD programs (Please click here for more information on PDF course in Movement Disorders and PhD Programs) and conducts research aimed at improved diagnosis and treatment of movement disorders. CCCMD is also actively involved in the dissemination of scientific knowledge.

Inauguration of the Comprehensive Care Centre for Movement Disorders, by Sri EK Nayanar, Chief Minister of Kerala.
Sri Arif Mohammad Khan, Hon’ble Governor of Kerala, inaugurated “MDSICON 2020”, an international conference of Movement Disorder specialists organised by the CCCMD of SCTIMST in 2020. The conference was attended by nine international faculty from the USA, Canada, UK, France and Australia; around 80 national faculty and more than 550 delegates from all over India and nearby SAARC countries.
CLINICAL SERVICES
MOVEMENT DISORDERS CLINIC

The Comprehensive Care Centre for Movement Disorders (CCCMD) conducts a weekly movement disorder clinic every Monday, dedicated to the follow-up treatment of all cases of Movement Disorders referred to this centre. Kindly note that the Movement Disorders Clinic does not register new cases directly and is dedicated to review / follow-up patients. Fresh patients referred for evaluation and treatment of movement disorders and coming to SCTIMST for the first time are registered as new cases in the general neurology outpatient clinic conducted by the faculty of CCCMD on Wednesdays and Thursdays and will subsequently be transferred to Movement Disorder clinic for follow-up. For first-time consultations for patients with Movement Disorders, kindly contact the Hospital Information Centre (0471-2524621) or CCCMD directly (0471-2524262) and fix up an appointment to register and consult in Neurology OP on Wednesdays or Thursdays). [Please click here for information on how to take appointment for consultation]

The common movement disorders referred to this clinic include Parkinson’s disease (PD) (Please click here to know more about Parkinson’s disease) other Parkinsonian disorders (“Atypical” Parkinsonism, Vascular Parkinsonism etc), which mimic Parkinson’s disease, other diseases causing tremor, various forms of Dystonia (click here to know more about dystonia ), Tics, Chorea, Myoclonus etc. Patients with movement disorders who are not controlled with optimal medical therapy are selected for surgical treatment from the movement disorders clinic. (Please click here to know more about surgical treatment of Movement Disorders) The clinic also provides counselling, education and neuropsychological and psychiatric evaluation and support. Physiotherapists attached to the clinic provide guidance on exercise regimens, avoidance of falls, improvement of mobility, walking aids etc. The clinic has 2000 to 2400 annual patient visits. Awareness programs are organized periodically for the patients and care givers to know more about their disease and the treatment options.

CCCMD regularly conducts awareness programs for patients with Parkinson’s disease, their care givers, and the general public, in connection with the World Parkinson day (April 11) every year
BOTULINUM TOXIN CLINIC

Botulinum Toxin Injections are used for the treatment of a wide variety of movement disorders. The program offers freehand and EMG-guided Botulinum toxin for all Movement Disorder indications, through the clinic. The centre has vast experience in Botulinum Toxin therapy and round 300-400 treatment sessions are conducted annually. (Please click here to know more about Botulinum Toxin Treatment) Botulinum toxin treatment is offered to patients with diseases like hemifacial spasm, blepharospasm, various forms of dystonia like neck dystonia, jaw dystonia and Writer’s cramp, and conditions causing “spasticity” including cerebral palsy and spasticity occurring after stroke.

Electromyogram is used to target the muscles correctly for Botulinum Toxin injections, in complex dystonic conditions.
MOVEMENT DISORDER SURGICAL PROGRAM

The CCCMD is one among the pioneers of Deep Brain Stimulation (DBS) surgery for Parkinson’s disease in India, with the first procedure of Globus Pallidus deep brain stimulation performed in 1999. It is currently one of the leading centres in this field in the country in the Government sector. Deep Brain Stimulation surgery is done under image- and micro-electrode recording (MER) guidance (Surgical Planning and Neuro-navigation systems). DBS treatment is also offered to patients with intractable Tremor and Dystonia. (Click here to know more about DBS) Those who are interested may also go through the information brochures in English and Regional Languages, available in the drop-down menu on the taskbar above under “Information for patients”.

Deep Brain Stimulation is an advanced stereotactic Neurosurgical procedure done for Parkinson’s disease and other selected movement disorders

The centre also undertakes MR-guided radiofrequency lesioning surgeries for Movement disorders. In these surgeries (e.g., Thalamotomy, Pallidotomy), a carefully planned “lesion” is made in certain crucial areas of the brain, so as to relieve the symptoms of movement disorders. These are generally considered when the patients cannot afford DBS, or there are some contra-indications for DBS surgery. A multidisciplinary dedicated team is involved in the systematic workup to assess suitability for DBS surgery, surgical planning, post-operative care and long-term management of patients who undergo DBS. Until 2023, the centre has performed over 500 surgeries for medically refractory Movement Disorders, including more than 300 DBS surgeries. The faculty have presented the results at several international meetings and published their experience in reputed international journals (Please see below, under “Selected Publications”).

PERMANENT FACULTY AND STAFF
Movement Disorder Specialists
Stereotactic and Functional Neurosurgeons