The clinic of Movement Disorders and Neurodegenerative diseases is one of CIREN’s assistential and Investigation units dedicated to the study and treatment of diseases on lesions of the nervous system (NS). These are characterized by alterations in motor control or by processes of a degenerative nature.
Its strategic objectives are to develop new therapeutic options to introduce and develop updated similar technologies for the obtainment of knowledge.
This issue optimizes therapeutic possibility for the attention of these alterations to impulse the development of specialized neurology in movement disorders and dementias.
This clinic is composed of teamwork specialized in: Neurology (2), Internal Medicine (l), Neuropsychology (l), Neurorehabilitation (4), specialists in motor rehabilitation, that is, 2 specialists in defectology and l specialist in speech therapy; 9 nurses (5 are registered ones). This Clinic also receives cooperation from specialists in other areas: 2 neuropsychologists, 1 neurosurgeon, 1 Neuropsychiatrist.
The present infrastructure includes 32 rooms (26 doubles) at the Neurovilla Area, 5 beds at the Investigation area and 1 bed at the Neurosurgery Service, for a total of 37 hospital beds under this Clinic’s responsibility.
The Assistential Service is organized within a general program of Neurologic Restoration and various Specialized sub-programs in diagnosis, assessment, prognosis and treatment of:
- Tremor and other involuntary movements
Besides, patients with other neurodegenerations as leucodystrophias, metabolic and mytochondrial diseases are evaluated and new therapeutic strategies, based on oxidative stress control and other mechanisms are developed. These mechanisms cause neuronal death, as they start from the individual’s determination through biochemical and molecular techniques from own patterns of self-defense and alterations of oxidative metabolism.
Investigative activities are organized within investigation projects and/or independent protocols aimed at perfecting functional stereotaxic surgery, by developing technologies linked to neuro-transplant and perfusion of trophic factors, as well as the evaluation of new agents or antioxidant combination. All this goes together with the creation and development of an exclusive integral rehabilitation technology – cognitive, motor and conductual – based on techniques that have been designed to stimulate neuroplastic mechanisms as well as to train motor control or cognitive processes with an individualized and intensive character.
The formation of CIREN’s personnel is guaranteed through its members’ participation in the institution’s teaching-learning program, the formation of residents in neurology, teaching activities in sub-directions of rehabilitation processes and nursing, as well as the Center’s weekly internal activities. International post-graduate courses and training in movement disorders as well as stereotaxic surgery are also offered. Fundamental observed results in the last 5 work years, include the attention to more than 2000 patients with these alterations. These are based on demonstrated efficacy in more than 90% of cases and a recovery degree that fluctuates between 20-25% (rehabilitation) and 40 –60% (surgical). The development of surgical techniques guided by microregister for the treatment of Parkinsons’s disease Are also performed as well as dystonias, tremor and other movement disorders.
The creation of a new surgical technique (dorsal subthalamotomy) is used for a more effective treatment of axial disorders in Parkinson’s disease. The perfecting of a rehabilitation methodology in parkinsonisms, ataxias, dystonias, and gait senile disorders is performed. The implementation of a combined system of antioxidants and other neuroprotector agents is offered too. In the last 10 years, CIREN’S staff has participated in more than 100 scientific meetings and more than 50 papers related to this issue have been published. One should also consider that his clinic is unique in our country and it was one of the first to be created within the western scientific complex and the very one to introduce the neurology specialty on movement disorders in Cuba.
Our immediate goals are aimed at the obtainment of new knowledge in the functional organization of the NS and specially of the motor system, by using imaging technologies (functional RMN, SPECT activation), neurophysiologic and psychophysiologic ones related to movement. Also dynamic ergometry and posturometry are performed for the exploration of molecular and biochemical substrate. This is done by means of biology and molecular immunology, spectroscopic RMN, degenerations, brain repairing processes and mechanisms for transplant and molecules with a trophic effect. An accumulated clinical experience and technology at the institution also allow to offer and avant-garde level of diagnosis for the approach of complex cases or non-common diseases with a high margin for diagnostic certainty.
Future personnel development is guided by procedures linked to obtaining scientific degrees and to a higher specialization of professionals.
Begun in 2000, a new system corresponding to the total quality work was put into practice and at the moment, operational normative procedure manuals are used with the aim of obtaining the certification to ISO9000 norms.
- Parkinson’s disease
- Multisystemic atrophies
- Progressive supranuclear paralysis
- Other degenerative parkinsonisms
- Wilson’s disease
- Induced parkinsonism by pharmas
- Other secondary parkinsonisms
- Torsion dystonias
- Huntington Chorea
- Sydenham Chorea and vascular choreas
- Late-induced dyskinesias by medicaments
- Hemibalism, choreoatetosis
- Familial essential tremor
- Post-traumatic tremor
- Mixed cerebellum ataxias
- Hereditary ataxias
- Gilles de la Tourette’s disease and other tics
- Muscular spasms and localized muscular masses
- Vertiginous syndromes
Degenerative Diseases of the Nervous System
- Alzheimer’s disease
- Lewy’s bodies disease
- Fronto-temporal dementias and other taupathies
- Circunscribed cortical atrophies
- Sub-cortical dementias
- Lacunar syndromes
- Multi-infarct dementias
- Post-infarct dementias
- Bingswaven’s disease
Other diseases and affections:
- Mytocondrial encephalopathies
- Care diseases
- Congenital metabolism errors (of late debut)
- Lisosomal diseases