ABOUT THE HYCY AND HOWARD HILL NEUROSCIENCE INSTITUTE

The Hycy and Howard Hill Neuroscience Institute at Providence Saint Joseph Medical Center, the Valley’s only comprehensive Neuroscience Institute, is committed to advances in the neurosciences, as we grow to meet the needs of our community and the specialized demands of advanced neurological care.

The brain is the body’s most complex organ. From tumors and movement disorders to spine surgery or stroke, it’s all about the outcomes. The Hill Neuroscience Institute successfully treats neurological disorders every day. With experienced staff and leading-edge technology, we offer full-service, comprehensive treatment. In addition, our Institute has received the following quality designations:

• Top 5 percent in the nation for treatment of stroke rating• Gold Seal of Approval™ from the Joint Commission for Advanced Primary Stroke Centers• Gold Plus Performance Achievement Award from the American Stroke Association• Approved Stroke Center (ASC) designation from the Los Angeles County Department of Health Services• President’s Award of Excellence from Providence Health & Services for the treatment of stroke

The Hycy & Howard Hill Neuroscience Institute offers:

The Hycy & Howard Hill Neuroscience Institute has earned its ratings as the health care provider Californians trust to deliver care – that’s HEADS ABOVE THE REST.

• Neurovascular Center offering Neurointerventional Radiology

• Movement Disorders Center offering Deep Brain Stimulation Surgery

• Certified Advanced Primary Stroke Center

• Neurodiagnostics Department

• CARF Accredited Acute Rehabilitation Center

• Balance and Vestibular Rehab

• Advanced Neuroimaging capabilities

• Leading edge procedures and technologies

• Clinical staff with advanced skills including neurological nursing

• Dedicated resources to enhance outcomes

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AGENDA & SPEAKERSCARE OF THE MOVEMENT DISORDERS PATIENT: A TEAM APPROACH

2011

Course Overview Tremor is the most common of all movement disorders, falling into three main categories: resting, action and postural tremor. The most common cause of resting tremor is Parkinson’s disease (PD).

Essential Tremor (ET), or non-physiologic tremor, has an estimated worldwide prevelence of up to 5 percent of the population. Although it often affects young individuals, the incidence of ET increases with age. ET may be associated with an increased risk for developing PD.

The incidence of PD increases rapidly in those over 60 years, with a mean age at diagnosis of 70.5 years. While the frequency of the disease is considerably higher in the over-60 age group, there is an alarming increase of patients of younger age. Considering the increased life expectancy in this country and, in Los Angeles County, in particular, an increasing number of people will be victims of PD.

Medications can be effective in managing movement disorders, including essential tremors, dystonia and PD. If medications do not work well enough, deep brain stimulation (DBS), may be an option.

DBS is currently the most frequently performed surgical procedure for the treatment of tremor, dystonia and advanced PD. DBS is non-destructive, can be performed bilaterally with low neurologic morbidity, and can be modified over time to deal with changing or progressing patient symptoms.

The purpose of this seminar is to raise awareness among general neurologists and primary care physicians of diagnostic tools for movement disorders and PD as well as evidence-based recommendations for optimal medical therapy, surgical options and rehabilitation. By promoting timely diagnosis and earlier and appropriate treatment, we hope to improve community outcomes in movement disorders and PD.

Performance Gap/Activity Statement The diagnostic approach to patients with tremor and other movement disorders involves a careful history, physical examination, and selected laboratory studies. Specific signs or symptoms contribute to the diagnosis.

Likewise, an accurate diagnosis of PD rests on the clinician’s ability to recognize its characteristic signs and associated symptoms, especially in the early stages.

Specific therapeutic goals for PD include earlier referral of PD patients for deep brain stimulation DBS before they have reached Stage 3 (postural instability), but after their medications have been maximized for tremor/rigidity, motor fluctuations, and dyskinesias. The multidisciplinary involvement of rehabilitation specialists, including physiatrists and physical therapists, plays a vital role in therapeutic goals for PD patients, and earlier referral is crucial.

Course Description/Format This will be a live, four-hour interactive event, including didactic instruction and hands-on skill sessions.

REGISTRATION Register online at www.providenceevents.org or via phone by calling the PSJMC Continuing Medical Education Department at (818) 847-3882. Registrations are due by September 16, 2011. Seating is limited. Validated parking is available in the Visitor Parking Lot off of Alameda Ave. and Buena Vista St. There is no fee to attend this conference.

CONFERENCE LOCATION Providence Saint Joseph Medical Center Bob & Dolores Hope Conference Center 501 S. Buena Vista Street Burbank, CA 91505

Targeted Learners Neurosurgeons, neurologists, internists, general/family practitioners, rehab therapists, nurses.

Learning Objectives At the end of the course/presentation, attendees will be able to:

• Recognize the signs and symptoms of PD and other movement disorders, conduct an appropriate work-up, and make the differential diagnosis.

• Treat PD and other movement disorders throughout the disease continuum according to evidence- based recommendations for medical therapy and rehabilitation.

• Explore myths and misconceptions about DBS.

• Identify patients who can benefit from DBS and refer at earlier stages.

• Interrogate or program a DBS device.

• Identify cultural diversity or disparity issues that impact the etiology and epidemiology of PD and other movement disorders or impede earlier treatment of PD and other movement disorders.

Accreditation Providence Saint Joseph Medical Center is accredited by the Institute for Medical Quality/California Medical Association (IMQ/CMA) to provide continuing medical education for physicians. Providence Saint Joseph Medical Center takes responsibility for the content, quality and scientific integrity of this CME activity.

Providence Saint Joseph Medical Center designates this live activity for a maximum of 3.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This credit may also be applied to the CMA Certification in Continuing Medical Education.

Neurologists may apply credits earned in this activity toward the 30 specialty credits needed per year over the 10-year Maintenance of Certification cycle.

PT Credit Pending approval for CEU’s for physical therapists through the California Physical Therapy Association (CPTA).

Contact For information regarding the conference, contact Jacqui Steltz-Lenarsky at (818) 847-3882 or by e-mail at Jacqueline.Steltz-Lenarsky@providence.org.

Support We gratefully acknowledge the education grant from Medtronic in support of this activity.

PROVIDENCE FACULTY

Ronald F. Young, MD, FACS Medical Director, Movement Disorders Center Hycy and Howard Hill Neuroscience Institute

Michael Marvi, MD, MS Movement Disorders Specialist Hycy and Howard Hill Neuroscience Institute

Michael Lupo, MD Medical Director, Acute Rehabilitation Center Providence Saint Joseph Medical Center & Providence Holy Cross Medical Center

SATURDAY, SEPTEMBER 24

7:30 a.m. - Registration/ Full Breakfast8:00 a.m. 8:00 a.m. - Welcome and Introductions 8:05 a.m. Margarita Oveian, MD Chair, Neurology Section, PSJMC 8:05 a.m. - Movement Disorders Primer 2011: 8:35 a.m. Patient Selection/When to Refer Michael Marvi, MD, MS 8:35 a.m. - Surgery for Movement Disorders: 9:05 a.m. DBS Implantation Protocol Ronald Young, MD, FACS 9:05 a.m. - Break 9:15 a.m. 9:15 a.m. - Skills Workshops10:15 a.m. Session 1 Hands-on DBS Targeting, (30 min) Stereotactic Frame and Microelectrode Recording Moderator: Ronald Young, MD, FACS

Session 2 DBS Programming (30 min) Moderator: Michael Marvi, MD, MS

10:15 a.m. - Break 10:30 a.m.

10:30 a.m. - After-care of the DBS Patient: Your 11:00 a.m. Role as Providers Michael Marvi, MD, MS 11:00 a.m. - Rehabilitation of the Movement 11:30 a.m. Disorders Patient With and Without DBS Michael Lupo, MD 11:30 a.m. - Break 11:40 a.m. 11:40 a.m. - Ask the Experts Panel12:00 p.m. Drs. Marvi, Young and Lupo 12:00 p.m. - Wrap-up & Evaluations12:05 p.m.