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Our services

The VCU Parkinson's and Movement Disorders Center strives to provide a seamless experience for the movement disorders community by providing access to clinicians from a variety of disciplines in one location. You may be referred by your doctor or you may directly make an appointment for yourself or a family member.

We offer evaluation and care for the full spectrum of movement disorders:

Make an appointment

Please call (804) 360-4NOW (4669) to schedule an appointment.


  • What is Ataxia?
    • Ataxia is a sign of an abnormality in the brain or nerves causing difficulty coordinating movements. It can effect walking, arm and leg control, speaking, swallowing and activities requiring fine motor control. There are many causes of Ataxia including stroke, certain vitamin deficiencies, drug or alcohol use, genetic diseases, Wilson’s disease, multiple sclerosis or cerebral palsy. Diagnosis is made through physical exam and certain tests depending on your history and exam.
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Corticobasal degeneration (CBD)

  • What is Corticobasal degeneration?
    • Corticobasal degeneration is a progressive neurological condition caused by abnormal tau protein in the brain cells. It causes symptoms similar to Parkinson’s disease such as rigidity, slowness of movement, tremor and imbalance. It can also cause cognitive impairment or dementia. It does not typically respond well to medications used to treat Parkinson’s disease, but there are ways to help manage symptoms such as providing supportive medications and therapies.
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Dementia with Lewy Bodies

  • What is dementia with Lewy Bodies?
    • Dementia with Lewy Bodies is a neurodegenerative disease causing fluctuating symptoms of progressive cognitive decline, Parkinsonism and hallucinations. It can also cause anxiety, depression and sleep disturbances. People with DLB are often very sensitive to medications used to treat Parkinson’s disease and do not tolerate them well, but there are ways to help manage symptoms such as providing supportive medications and therapies.
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Dystonia and torticollis

Essential Tremor

Huntington's Disease

Multiple System Atrophy (MSA)

  • What is Multiple System Atrophy?
    • Multiple System Atrophy is a progressive neurodegenerative disorder caused by abnormal accumulation of alpha synuclein proteins in the brain. It is similar to Parkinson’s disease and is characterized by rigidity, tremor, slowness of movement and instability. It is also associated with autonomic nervous system problems such as low blood pressure and sensation of light headedness, urinary incontinence, and lower leg swelling. Some patients also have abnormal coordination. It does not typically respond well to medications used to treat Parkinson’s disease, but there are ways to help manage symptoms such as providing supportive medications and therapies.
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  • What is Myoclonus?
    • Myoclonus is an abnormal neurological sign, not a disease. It is characterized by sudden, involuntary, abnormal jerking of muscles. It can be benign or associated with a variety of neurological diseases. Myoclonus can be treated with medications.
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Parkinson's Disease

Parkinsonism/Parkinson-Plus Syndromes

Progressive Supranuclear Palsy (PSP)

  • What is PSP?
    • Progressive Supranuclear Palsy (PSP) is a neurodegenerative disease caused by abnormal accumulation of tau proteins in the brain. It causes symptoms similar to Parkinson’s disease with slowness, stiffness and tremor. It can also cause slowness of eye movements, mood and cognitive changes and early falls. It often does not respond well to medications used to treat Parkinson’s disease, but there are ways to help manage symptoms such as providing supportive medications and therapies.
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Restless Legs Syndrome

  • What is Restless Legs Syndrome?
    • Restless legs syndrome (RLS) is a neurological condition which causes abnormal sensations in the legs and sometimes arms resulting in an uncontrollable urge to move. Movement helps relieve the symptoms temporarily. Symptoms generally occur at night, but can occur during the day as well when trying to rest or relax.
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Tardive Dyskinesia / Tardive Dystonia

  • What is Tardive Dyskinesia?
    • Tardive Dyskinesia is a neurological disease causing abnormal and involuntary movements. Most often, these movements are seen in the tongue, lips and face, but they can also occur in the arms, legs or torso. It is caused by taking certain medications for psychiatric or gastrointestinal disorders, usually for long periods of time.
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Tics and Tourette Syndrome

  • What are Tics?
    • Tics are involuntary, repetitive movements (motor tics) and vocalizations (vocal tics). Tics are usually associated with a sensation or urge to perform the tic (premonitory sensation) followed by a sense of relief afterwards. They are a symptom of neurodevelopmental disorders which begin in childhood. Tourette syndrome is a tic disorder characterized by having a combination of two motor tics and one vocal tic for one year or more. Education, environmental adaptations and medications can help manage symptoms.
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Wilson's Disease

  • What is Wilson’s Disease?
    • Wilson’s disease is a rare genetic disorder causing abnormal accumulation of copper in the liver, brain and other organs. Symptoms can include fatigue, yellowing of the skin, abdominal pain, abnormal movements, depression and anxiety. It is diagnosed with laboratory tests and treated with chelation, medications and diet changes.
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Writer's Cramp and Musician's Cramp

  • What is writers/ musicians cramp?
    • Writers and Musicians Cramp is a type of focal dystonia causing abnormal and involuntary contractions of hand muscles when performing specific activities such as writing or playing a musical instrument. It can be treated with exercises, adaptive techniques, botulinum toxin injections or medications.
    • Also see “Dystonia”
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Interdisciplinary evaluation

The VCU Parkinson’s and Movement Disorders Center interdisciplinary evaluation allows patients to access sub-specialty care providers in one location. This evaluation will include assessments by the professionals described below, and will result in a comprehensive treatment plan that will address each individual's needs. This treatment plan will be shared with other healthcare providers managing a patient's care.

  • Movement Disorder Neurology
    • The movement disorder neurologist evaluation includes assessment of symptoms, including non-motor features such as gastrointestinal and sleep problems.
  • Clinical Neuropsychology [PDF]
    • The neuropsychologist examines thinking skills such as attention, speed of thinking, visual and language skills, learning and memory, problem-solving, reasoning, and other brain and behavior functions including mood and quality of life.
  • Genetic Counseling
    • The genetic counselor is available to discuss genetic testing, including pre-symptomatic testing for Huntington Disease.
  • Rehabilitation [PDF]
    • The physical therapist evaluates conditioning, balance, coordination and motor skills.
  • Speech and Language Pathology [PDF]
  • Speech Therapy
    • The speech therapist evaluates speaking and swallowing.

As part of VCU Medical Center, our patients have access to other services as recommended by our team.

Care and treatment

We offer state-of-the-art medical and surgical treatment options. Our movement disorders specialists are able to provide individual treatment recommendations and referrals as appropriate.

Dr. Sarah Lageman consults with patientsOur center offers access to a variety of treatment options, including:

Our team will provide recommendations and work with you and your family to determine the best treatments for you.

Other services

Other services available include geriatric psychiatry, genetic counseling, and evaluation for Deep Brain Stimulation (DBS) surgery and post-surgical DBS programming.

Telemedicine services

We offer telemedicine consultations to patients on Virginia's Eastern Shore in partnership with Dr. Robert Paschall of Riverside Neurology Specialists.

Dr. Leslie Cloud conducts a telemedicine visit

Telemedicine uses secure technology to connect two locations with video and sound through a computer, allowing for access to our specialists without having to travel long distances.

Patients go to Dr. Paschall's office, where a computer with special video equipment will securely connected to a similarly equipped computer at the VCU Parkinson's and Movement Disorders Center in Richmond. Dr. Leslie Cloud is the VCU neurologist who provides these consultations. She talks with the patient and family members using a video chat program on the computer. The computer software and connections are secured using special technology to ensure that private health information is protected.

Dr. Cloud provides advice for ongoing care and treatment for patients with movement disorders, and Dr. Paschall and his office help to facilitate any follow-up testing or prescriptions.

Dr. Paschall and his staff arrange telemedicine appointments. Please contact his office at (757) 442-6600 with any questions or to set up an appointment.

HDSA Center of Excellence

HDSA Center of Excellence logoOur Huntington Disease program has been designated a Center of Excellence by the Huntington’s Disease Society of America. Our team of experienced providers is dedicated to providing interdisciplinary consultations to meet our patients’ individual needs. We strive to integrate expert clinical care with clinical research to advance knowledge in HD.

Our program is one of 29 selected nationwide for this prestigious designation, reserved for programs committed to collaborative, multidisciplinary care for HD affected families.

Huntington Disease (HD) is an inherited neurodegenerative disease.  HD is most often thought of as a movement disorder, but it also causes emotional and behavioral changes, and cognitive decline.  The symptoms associated with HD usually become more severe over time.  Currently there is not a cure for HD, but there are medications to manage the symptoms.  There are also many other ways to improve a person’s independence and quality of life.

Learn more about our HD Program.

Resources and education

In additional to clinical care services, we also offer resources and education opportunities. You do not have to be a current patient to participate.

We also host two support groups at our center:

  • Richmond Metro Huntington Disease Support Group
    Meets the 2nd Tuesday of each month at 6pm
    Contact Ginger Norris, virginia.norris@vcuhealth.org or (804) 628-2022
  • Women's Support Group - for women diagnosed with Parkinson's disease or other movement disorder
    Meets the 2nd Friday of each month at 10am
    Contact Susan Chandler, pdcenter@vcuhealth.org or (804) 628-2022

Other support groups are available and we maintain a listing of groups in Virginia for:

Financial assistance

If you worry that you may have difficulty paying your bill for your care in full, VCU may be able to help.  It is important that you let us know if you will have trouble paying your bill or balances after insurance. For more information about financial assistance please, please visit the VCU Medical Center website.

Patient Care


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