I am a neurologist with special training in the treatment of movement disorders. In an outpatient setting, I care for patients with Parkinson’s disease, Huntington’s disease (HD), generalized and focal dystonia, essential tremor, Tourette’s syndrome, tardive dyskinesia, progressive supranuclear palsy, multiple systems atrophy, ataxias, and other movement disorders. I perform botulinum toxin injections for dystonia, blepharospasm and sialorrhea. I also care for patients with neurological disorders when they have been admitted to Buffalo General Medical Center (BGMC). I am the Director of the Deep Brain Stimulation (DBS) program at the University at Buffalo. I evaluate patients to determine if DBS surgery will help alleviate their neurological symptoms; if it will, I perform intraoperative electrophysiology monitoring during DBS lead placement. I also program patients’ neurostimulator system following DBS surgery. I collaborate closely with my neurosurgical colleagues from UBMD Neurosurgery and DBS team members to provide an integrated treatment plan for each of my patients. I am the Director of the University at Buffalo Huntington Disease Society of America (HDSA) Center of Excellence that provides full care for individuals with HD. HD is a dominantly inherited genetic disease: each child of a parent with HD has a 50 percent chance of inheriting the disease from their affected parent. Our HDSA Center of Excellence ensures that patients receive a team- and family-centered approach to their care—i.e., in addition to the medical care patients receive from me, they and their families receive support from a social worker and a genetic counselor. We also offer counseling and genetic testing for individuals that are at risk of having HD. To set up an appointment in the University at Buffalo Huntington‘s Disease Clinic or learn more information about predictive testing for individuals at risk for HD please contact our scheduler at 716-932-6080. I also teach residents and medical students in clinic and on the general neurology service at BGMC.
Movement Disorders; Neurology; Parkinson's
I am a movement disorder neurologist, and I care for patients with involuntary movements such as Parkinson‘s disease, tremor disorders and dystonia at our UBMD neurology clinic on Main Street in Williamsville. I manage the care of patients with medication and counseling, and I also perform botulinum toxin (Botox) injections to treat dystonia, blepharospasm, hemifacial spasm, spasticity and certain types of tremors and headaches. I collaborate with UBMD neurosurgeons specializing in movement disorders in order to give patients the best possible and coordinated care. For instance, I refer patients to my neurosurgery collaborators for deep brain stimulation (DBS) when I know this surgical therapy treatment will help my patients. I am also a member of the Parkinson Study Group, an international organization of clinical research centers, and the International Parkinson and Movement Disorder Society. My involvement with these groups allows me to identify opportunities for my patients to enroll in cutting-edge research studies and clinical trials that could benefit them. My research has focused primarily on conducting clinical trials with the goal of finding new treatments for a variety of conditions. These conditions have included hot flashes, chemotherapy-induced nausea, hyperemesis gravidarum and Parkinson‘s disease. Thus far, my research has shown the drug gabapentin to be an effective treatment for hot flashes in postmenopausal women and to possibly be an effective treatment for nausea and vomiting conditions that do not respond to more conventional therapies. More recently, I have become interested in the use of lithium carbonate for treating certain symptoms that Parkinson‘s disease patients frequently experience. In addition, I am collaborating with the Buffalo Neuroimaging Analysis Center, the University of California at San Francisco and the University of Pennsylvania to assess MRI imaging modalities called diffusion tensor imaging and quantitative susceptibility mapping to determine if these can more objectively measure brain changes over time in patients with Parkinson‘s disease. Validation of such measures will be essential for identifying ways to slow the progression of symptoms in Parkinson‘s disease. I also teach medical students and residents about movement disorders in classroom settings as well as at the bedside in my outpatient clinic and on inpatient rounds at Buffalo General Medical Center.
Children and Adults; General Neurology; Movement Disorders; Neurodegenerative disorders; Neurology; Parkinson's; Tourette's Syndrome
I received my medical degree from the University of Otago Medical School in New Zealand in 1977 and, following further advanced training in general medicine and Neurology was elected to Fellowship of the Royal Australasian College of Physicians in 1984. On completion of a Neurology residency and fellowship in Movement Disorders at the University of Rochester (1988), I joined the faculty of the Department of Neurology at the University at Buffalo. As a Clinical Professor at UB, I am engaged in patient care and the teaching of students, residents and fellows at the VA Medical Center. I also have a focused Movement Disorders clinic at the Brain and Spine Center (Williamsville, NY). My interests include not only disorders of voluntary movement but also the associated cognitive, behavioral and psychiatric dysfunction commonly accompanying such disorders. Accordingly, I conduct clinical studies in Movement Disorders not only with my Neurology and Neuroimaging colleagues at UB, but have also collaborated on clinical studies in Tourette syndrome with colleagues from the UB Department of Psychiatry, where I have a secondary appointment, and with members of the Division of Developmental and Behavioral Neurosciences. My publications include co-editing a textbook on “Frontal-Subcortical Circuits in Psychiatric and Neurological Disorders” (Guilford Press, 2001). I am an active member of the American Academy of Neurology, the Movement Disorders Society, the Tourette Syndrome Association, the American Neuropsychiatric Association, and the Royal Australasian College of Physicians.