New illnesses such as progressive supranuclear palsy and corticobasal ganglionic degeneration have been recognized. Disorders such as torticollis, writer's cramp and Gilles de la Tourette syndrome, previously believed to be psychogenic are now thought to have an organic etiology amenable to medications. There are large enough numbers of patients that most academic medical centers in the US have been creating their own movement disorders unit. In Rhode Island alone, there are an estimated 2000 patients with Parkinson's disease. It is a field rich in phenomenology, where the history and the physical examination are everything.
Laboratory tests including imaging studies are usually of little value.
And, although we know a great deal about these various disorders, answers to the basic problems remain elusive. The phenomenological complexity of this field lies somewhere between the simplicity of nerve and muscle disorders and the daunting complexity of behavioral, language and cognitive dysfunction. The disorders have taught us important lessons about normal brain biochemistry and are providing insights into various psychiatric problems and their chemical underpinnings as well. The field is treatment oriented. It gives the lie to the belief that neurology is solely a diagnostic field of intellectual interest.