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Inova NeurosciencesInova Parkinson’s andMovement Disorders Center

2Specialty Care for Parkinson’s, Essential Tremor, Dystonia and Other Movement DisordersWhether it’s Parkinson’s, essential tremor, dystonia or another movementdisorder, the Inova Parkinson’s and Movement Disorders Center providescomprehensive care that can help. These conditions can take a toll on everyaspect of your life, impacting not only movement, but also mood, cognition andother cognitive changes. Because each individual is unique, every person facingParkinson’s, essential tremor, dystonia, Huntington’s disease or tic disorderrequires an individualized treatment plan. If you are living with one of theseconditions, it is important for you to be followed by a team of movement disordersspecialists. With specially trained neurologists and neurosurgeons offering leading-edge medications, technology and therapies, the team of experts at the Inova Parkinson’s and Movement Disorders Center will work with you to restore the quality of life you deserve. We rely on our in-depth understanding of available treatments to find the right therapeutic combination to meet your specific needs. And if medications are not sufficient, the team at Inova is uniquely qualified to use deep brain stimulation (DBS), dopamine intestinal gel and targeted botulinuminjections to help revitalize your quality of life.Leading-Edge Research, Close to HomeBe it new therapeutic options, novel treatments or new imaging tests, the Inova Parkinson’s and Movement Disorders Center is a respected clinicalresearch institution. This is part of our dedication to providing the highest levelof multifaceted and comprehensive care. Through this center, you have theopportunity to participate in new drug and imaging trials. Our specialized teamof neurological researchers is actively enrolling patients in multiple clinicaltrials that span everything from industry-driven new drug trials to morefocused, investigator-initiated trials. Through your partnership and participation, combined with our center’s extensive research studies, we can advance this field and improve lives, now and into the future. Bachir Flih, also featured on the cover, lived with Parkinson’s disease for 11 yearsbefore pursuing treatment options. After surgery, he felt significant relief from hissymptoms. He now lives a confident and happy life. Watch Bachir’s story at inova.org/move.

3Treating the Whole PatientFrom your first moments within the Inova Parkinson’s and Movement DisordersCenter, you will understand the team’s dedication to individualized care. We willdevelop a treatment plan to address your unique symptoms and concerns.Inova’s multidisciplinary team of neurologists, neurosurgeons, neuropsychiatristsand neurophysiologists, as well as physical, occupational and speech therapists,have dedicated their careers to understanding and treating the followingconditions:Parkinson’s and parkinsonisms, including multisystem atrophy (MSA),progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) Lewy body dementia and Parkinson’s dementia syndromesEssential tremor and other tremorsDystonia, spasticity, blepharospasm, writer’s cramp and other tone issues, including those resulting from multiple sclerosis, stroke or neurological injuryExcessive salivationTic disordersHuntington’s and other hyperkinetic movement disordersOther movement disordersAlong with a review of your medical history, you will be given a thorough medicalexamination, neuroimaging and review of your medications to ensure optimaltherapy and a comprehensive treatment plan. We share the same goal as ourpatients – to end symptoms of your disease.We accomplish this goal through the latest targeted medications to improve your natural neurochemistry. We also prescribe disease-specific physical, occupationaland speech therapy to improve walking, fine motor movements, balance, speechand more. Our team has access to leading-edge neuroimaging and advancedtechnology, including DBS and dopamine intestinal gel, as well as specializedEMG-guided botulinum toxin injections. We also educate on, and encourage theinclusion of, lifestyle changes. “I have been fantastic since the surgery. I have been a totally different person. I move better, I write better, I thinkbetter.”– Bachir FlihThe result of this team-based approachensures you will have access to the best possible treatments for your specific condition.

4– Wayne Lewis“So thankful for the technology that’s beendeveloped and the medicationthat’s available. It’s been apleasure working with Drs.Falconer and Shenai.”Wayne Lewis has a strong faith and plays anactive role in his community. After completing DBS, he looks forward toplaying with his grandchildren, without thelimitations of Parkinson’s. Watch Wayne’s story at inova.org/moveKaren Troutman had an essential tremor for more than 20 years. As a result of herDBS treatment, Karen can now sew, andher quality of life has significantly, andpermanently, improved. Watch Karen's Story at inova.org/move.“During surgery, I feltcompletely in control.I knew exactly whatwas happening.”– Karen Troutman

5Deep Brain Stimulation (DBS)80 – 90% patient satisfaction with symptom control 60% reduction in medications 60% reduction in dyskinesias80% improvement in “off” periods10% improvement in “on” periodsImprovement in periods of good mobility from 27% to 74% of theday.80% improvement in tremor70% improvement in handwritingSignificant reduction in medicationsUp to 30% of patients with Parkinson’s disease are good candidates for DBS. In essential tremor, this percentage is significantly higher.DBS is also indicated as a treatment for some forms of dystonia.State-of-the-art operating room designed for DBSAbility to perform MRI-guided DBS, in which the procedure isperformed “asleep” under anesthesiaMedtronic, Boston Scientific and Abbott Directional devices availableComplete multidisciplinary team care under one teamHome to nationally recognized DBS programming specialists who train other physicians in DBSOption for remote DBS programming through telehealthEssentially a pacemaker for the brain, DBS is an invaluable tool to improve thesymptoms of Parkinson’s. Implanted by our highly specialized neurosurgeonsand programmed by our movement disorders specialists, this technology goesdirectly to the source and delivers a carefully controlled stimulation of electricityto targeted areas, interrupting the brain’s faulty signals. With proper screening, programming and medication adjustments, DBS offers the following exceptional results, on average:Essential TremorParkinson’s DiseaseWhy Choose Inova for DBS?123

61) Krack et al. Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med. 2003 Nov 13; 349(20):1925-34. 2) The Deep-Brain Stimulation for Parkinson’s Disease Study Group,N Engl J Med 2001; 345:956-963, 2001.3) Gross et al. Deep Brain Stimulation in Parkinson’s Disease, Ther Adv Neurol Disord. 2009 Nov; 2(6): 20–28. As your disease changes over time, the device can be adjusted to better addressnew or worsening symptoms. DBS is completed in three stages: implanting theelectrodes in our state-of-the-art surgical suite, implanting the neurostimulatorand programming by our specialists. The process usually occurs over six weeks.DBS provides superior improvements in quality of life and motor symptoms, compared to medications alone.With the Neurosphere™ Virtual Clinic, DBS programming and adjustments canbe made remotely through secure telehealth, extending the option of virtualclinical visits for patients with DBS devices.Our movement disorders team uses the latest in revolutionary treatment to truly impact your life.Dr. Mahesh Shenai performs DBS surgery.

7Botulinum Injections Duopa™ Intestinal Gel Pump Duopa is not a pill– it’s a suspensionform ofcarbidopaandlevodopathat isdelivered continuously into the intestine over 16 hours through a tube. Duopais delivered by a small portable pump, which you carry or wear as you goabout your day. Our specialists utilize this device because of its ability to:Increase “on” time by four hours on average Decrease “off” time by four hours on averageGive consistent dosing for 16 hours, fully replacing oral medications during the dayDeliver an exact dose of medicationInova’s movement disorders specialists are trained in the art of botulinuminjections, including Botox®, Myobloc®, Xeomin® and Dysport®. We haveexperience dosing, mixing and administering this therapy, ensuring that you willquickly experience the benefits of this treatment, without the risk of side effectspresent with oral medication. Utilizing EMG technology to ensure accurate placement, injections can significantly improve the pain, tightness and disfiguring muscle contractions of: Cervical dystoniaSegmental dystonia of arms, legs, neck and trunkWriter’s crampBlepharospasm, hemifacial spasm and Meige syndromeTremorAll forms of spasticity, including post-stroke spasticityBotulinum injections are also extremely effective in the treatment of excessive saliva, drooling or sweating.Inova Parkinson's and Movement Disorders CenterAdvancing the quality of life of those living with Parkinson’s disease through education, wellness, and community.

Mahesh Shenai, MD, MSE, MBA,NeurosurgeonInova Parkinson’s and Movement Disorders Center TeamRamsey (“Drew”) Falconer, MD,Movement Disorders Specialist andMedical Director, Inova Parkinsonand Movement Disorders Center Sean Rogers, MD, PhD, Movement Disorders Specialist andMedical Director, Memory DisordersDavid Whitney, MD, Movement Disorders SpecialistAbigail Lawler, MD, Movement Disorders Specialist andAutonomic Disorders DirectorHannah Irving, MD, Movement Disorders SpecialistSonia Gow,Program and Community Care ManagerKyla Newman,Physician AssociateFor an appointment, please call 703.845.1500. For program and community care resources and support, please email sonia.gow@inova.org or call 703.375.9987.8Meet Our Team at inova.org/move Mick Reedy, MD, Movement Disorders SpecialistJenn Pauldurai, MD, Behavioral and Cognitive Neurologist

9IPMDC hosts or sponsors over 100 online and in-person, educational, wellness, and supportive programs each month.Details at ipmdc.orgOnline Wellness ProgramsDual Task for Parkinson's - Mondays and WednesdaysZumba Gold for Parkinson's - Tuesdays and ThursdaysVoice, Speech and Communication - TuesdaysOnline Educational Programs - MonthlyCare Partner Tips & TricksRecently Diagnosed Boot CampCommunity Chit ChatConference ContinuedGuest SpeakersHealth EatingIn-Person Wellness Programs - weeklyRock climbing - Alexandria, SterlingDance for PD - Fairfax, Falls ChurchBoxing / strength - Lake RidgeTherapy classes - Fair Oaks, Leesburg, Chantilly, FairfaxIn-Person Social & Supportive ProgramsFairfaxFalls ChurchManassas/GainesvilleSterlingWoodbridgeLynchburgA Trusted Partner Caring for Our CommunityWe pride ourselves on being a nationally recognized Parkinson’s andMovement Disorders Center, anchored in the community in which we live. As part of our approach to individualized care and accessible support for ourcommunity, we are expanding our offerings in order to provide you withresources, support and encouragement to help you live the life you deserve. Get Involved!Join our newsletter to keep up with the free offerings of our center including: • World-class education • Exercise programs • Wellness initiatives • And more!Subscribe for our weekly e-newsletter at ipmdc.org/newsletter.

10ipmdc.org for ResourcesFor more information, please contact our Program and Community Care Manager, Sonia Gow at sonia.gow@inova.org, or call 703.375.9987.Providing local / national / international resourcesAt ipmdc.org you'll find information about the individuals and organizationswe feature in our programs, with everything from local physical, occupational,and speech therapy teams that specialize in Parkinson's, to recordings andslide decks from educational programs.Here are some examples of the resources you'll find:IPMDC on the InternetLooking for recordings of presentations by our specialists? We’ve postedthem on this page along with articles that feature IPMDC.Patient AssistanceInformation about communicating with your doctor, a list of patient supportprograms offered by pharmaceutical companies, communicating for deafand hard of hearing persons, and managing a healthcare crisis.Therapy teamsInformation about the therapy teams work with in northern Virginia – all withParkinson experts.Hospital Patient Care for Parkinson'sDownload our leaflet to share with your hospital team. It includes basicinformation about Parkinson's as well as commonly prescribed medicationsand contraindicated medications.Veterans BenefitsVeterans living with Parkinson’s and other conditions are entitled benefitsthat can reduce the costs for their care. Families are also eligible forbenefits. You’ll find information about these benefits and contact informationfor people who are happy to help you work through the process.

Giving Back Through Philanthropy You can request memorial donations be made to the center in memory of a loved one. These are also a meaningful way to honor someone whose life has been affected by Parkinson’s.Please visit inova.org/donate to make a contribution. If you would prefer to send a check, please note “Inova Parkinson’s andMovement Disorder Center” on the check, and mail to: Inova Health Foundation ATTN: Janet Filip 8095 Innovation Park Drive Fairfax, VA 22031For questions about donating, including planned giving and arrangingyour personal fundraising campaign, please contact Janet Filip, Executive Director of Philanthropy, at janet.filip@inova.org or 703-776-3328. IPMDC programs are offered at no costwith thanks to the generosity of:The Inova Narang Foundation Active Living and Fitness Program,and members of our community.Your gift of gratitude to the Inova Parkinson’s and MovementDisorders Center has the power to directly benefit all Parkinsonpatients, their families and friends. All donations to Inova are tax-deductible as we are a 501(c)(3) organization.Every day, our healthcare team provides exceptional care, giving hope topatients and their families. Your gift of gratitude to the Inova Parkinson’sand Movement Disorders Center has the power to directly support ourprograms, including groundbreaking research, patient education, directpatient and caregiver support, and expansion of our current supportgroups, along with wellness initiatives such as Parkinson’s specific dual-task, dance, all offered at little to no cost to our community.11

Inova NeurosciencesInova.org/MoveFor either an in-person or telehealth appointment, please call: 703.845.1500For information, visit: inova.org/moveFor program and community care resources and supportplease call: 703.375.9987 or email: sonia.gow@inova.orgAppointments and InformationLocationsInova Neurology – Alexandria 1500 N. Beauregard St., Suite 300 Alexandria, VA 22311 703.845.1500 Inova Neurology – Fair Oaks 3580 Joseph Siewick Dr., Suite 206 Fairfax, VA 22033 703.391.4500Inova Neurology - Leesburg44055 Riverside Parkway, Suite 242 Leesburg, VA 20176Inova Neurology – Fairfax 8081 Innovation Park Dr., Suite 900 Fairfax, VA 22031571.472.4200 Inova Neurology – Gainesville 7051 Heathcote Village Way, Suite 230 Gainesville, VA 20155703.391.4500 Inova Neurology - Dumfries3800 Fettler Park, Suite 312Dumfries, VA 22025G39840/10-23