Quick Answer
Tremor is separated primarily by when it appears: at rest points toward Parkinson’s disease, in use toward essential tremor. Neither is diagnosed by a scan. Assessed at 1691 W. Horizon Ridge Parkway, Suite 100, Henderson NV 89012. The practice is physician-owned and has served Southern Nevada since 1998.
Part ofThis guide sits beneath parkinson's disease and tremor, which covers the study itself, how it is performed and what the report should contain.
how CNS approaches Parkinson's Disease and Tremor →Key Takeaways
- Dystonia produces sustained involuntary contraction, often pulling a body part into a fixed posture.
- Cervical dystonia affects the neck and is frequently misattributed to muscle strain for years.
- A sensory trick, where touching the face eases the pulling, is characteristic and diagnostically useful.
- Botulinum toxin injection is the mainstay for focal dystonia and repeats on a schedule.
- Assessed and treated at 1691 W. Horizon Ridge Parkway, Suite 100, Henderson NV 89012. No cosmetic injections are performed.
Parkinson's disease
Parkinson's disease is a progressive disorder of the brain's movement-control circuits, caused by loss of dopamine-producing cells. It is diagnosed clinically from slowness of movement combined with rest tremor or rigidity.
Sustained pulling rather than shaking
Dystonia produces sustained involuntary muscle contraction, pulling a body part into an abnormal posture or twisting movement. It is not a tremor, and the difference is what gets it recognised.
Why it takes years to name
Cervical dystonia, the commonest focal form, pulls the head to one side or forward or back. Patients present with neck pain and a head that will not sit straight, and it is attributed to muscle strain, arthritis or posture, sometimes for years. Physiotherapy and massage are tried, occasionally with brief benefit, and the underlying neurological cause is never named. Writer’s cramp affecting the hand, and blepharospasm affecting forced eye closure, follow similar paths through other specialties.
The sensory trick, which is diagnostically useful
Many patients discover that a light touch to the face, chin or back of the head temporarily eases the pulling. That phenomenon is characteristic of dystonia and unusual in musculoskeletal problems, so it is worth mentioning if you have found one. Patients frequently assume it is a coincidence or too odd to report, and it is one of the more useful things they can say.
What distinguishes it from what it is mistaken for
Pain is common in cervical dystonia and can dominate the presentation, which is part of why it gets treated as musculoskeletal. What separates it is the sustained directional pull, the fact that the posture is involuntary rather than habitual, and frequently a tremor superimposed on the pulling. A neck that can be straightened passively but pulls back on release is behaving differently from a stiff joint.
What treatment consists of
Botulinum toxin injection into the affected muscles is the mainstay for focal dystonia, given on a repeating schedule with effect building over days and lasting a period before repeating. It reduces the pulling and the associated pain rather than abolishing the condition. Oral medication has a role in some presentations, and physical therapy alongside rather than instead.
| Also considered | How it is distinguished |
|---|---|
| Essential tremor | Tremor appears with action and posture rather than at rest, is often symmetric, and frequently runs in families. |
| Drug-induced parkinsonism | Follows exposure to dopamine-blocking medication and is usually symmetric; a medication review comes first. |
| Atypical parkinsonian syndromes | Early falls, prominent autonomic change or poor levodopa response point away from typical Parkinson's. |
| Dystonic tremor | Accompanied by abnormal posturing of the affected part. |
What the practice does
01
What brings people in
A new tremor, slowness, changed handwriting or gait, or an existing diagnosis that needs review.
02
What the evaluation settles
When the tremor appears — at rest, with posture, or with action — which syndrome the examination fits, and whether medication or another cause is contributing.
03
What you leave with
A clinical diagnosis where the examination supports one, a treatment discussion, and a follow-up interval to confirm the diagnosis over time.
Diagnosis first, and it is clinical
Dystonia is diagnosed by examination and history rather than by any scan. Imaging is used to exclude other causes where indicated. The examination looks at the direction of pull, whether a sensory trick works, whether tremor is superimposed, and which muscles are actually driving the posture, since that determines where treatment is directed.
Botulinum toxin, administered for clinical indication
Injections are targeted at the specific muscles producing the pull, which is why identifying them matters and why the same dose placed differently produces different results. It repeats on a schedule, and the interval is set against how the effect wears off for you rather than by a fixed rule. Worth stating plainly: the practice performs no cosmetic injections, and this is a neurological treatment for a diagnosed condition.
Both offices, adults only
Assessment and treatment are available at both addresses on the locations page. Adults 18 and older. Physical and occupational therapy are coordinated externally rather than delivered here, and they matter alongside injection rather than as an alternative.
What is not provided
No surgery, so deep brain stimulation for dystonia is implanted elsewhere, though implanted devices are programmed and followed up here. No interventional pain programme. No inpatient care.
The first 30, 60 and 90 days
Step 1
First visit
History and neurological examination, a review of records and prior imaging, and a decision on which studies are actually indicated. You leave with the plan, not just a referral.
Step 2
Within 30 days
Indicated in-office studies are performed and interpreted by the neurologist who ordered them, in our AANEM-accredited laboratories. Results are explained in plain language.
Step 3
60 to 90 days
Follow-up to judge whether the plan is working, adjust it, and coordinate with your referring clinician. Where a diagnosis needs time to confirm, this is where it is revisited.
Attending from Henderson
The Henderson office is at 1691 W. Horizon Ridge Parkway, Suite 100, just off the 215 Beltway, with parking on site. All six in-office studies are performed and interpreted there, so nothing is sent across to Las Vegas. Green Valley, Anthem, Whitney and Boulder City are generally closer to it than to Flamingo Road. Adults 18 and older.
Noticed a tremor or a change in movement?
Note when it appears rather than how bad it is, and bring your full medication list.
The Bottom Line
Sustained pulling rather than shaking, and frequently misattributed for years. Botulinum toxin repeats on a schedule.
Frequently Asked Questions
What is dystonia?
Sustained involuntary muscle contraction that pulls a body part into an abnormal posture or twisting movement. It is not a tremor, though a tremor is frequently superimposed on the pulling. It can affect the neck, the eyelids, a hand or the voice, and it is named for the part involved rather than treated as one single condition.
Why is cervical dystonia missed for so long?
Because patients present with neck pain and a head that will not sit straight, and it is attributed to muscle strain, arthritis or posture. Physiotherapy is tried, sometimes with brief benefit, and the underlying neurological cause is never named. The head position itself is the clue: a consistent direction of turn or tilt is not what muscle strain produces.
What is a sensory trick?
A light touch to the face, chin or back of the head that temporarily eases the pulling. It is characteristic of dystonia and unusual in musculoskeletal problems, so it is worth mentioning. Patients often assume it is coincidence or too odd to report. Mention it even if it sounds trivial, because it is a recognised diagnostic feature.
How is it diagnosed?
By examination and history rather than by any scan. The examination establishes the direction of pull, whether a sensory trick works, whether tremor is superimposed, and which muscles are driving the posture, since that determines where treatment goes. Photographs or a short video of the posture at its worst help, since it varies through the day.
What does treatment involve?
Botulinum toxin injected into the specific muscles producing the pull, on a repeating schedule with effect building over days. It reduces the pulling and associated pain rather than abolishing the condition. Oral medication has a role in some presentations. Sessions repeat on a fixed interval, so appointments are scheduled in advance rather than arranged when symptoms return.
Is this the same as cosmetic Botox?
No. This is a neurological treatment for a diagnosed condition, targeted at the muscles driving an abnormal posture. The practice performs no cosmetic injections. The muscles targeted, the doses used and the intervals are all different, and it is billed as a medical treatment, which affects how your insurance handles it.
Does physiotherapy help?
Alongside injection rather than instead of it. Physical and occupational therapy are coordinated externally, and they matter, but used alone for dystonia they frequently disappoint because the driver is neurological. Therapy timed to the weeks when the injection effect is strongest tends to be more productive than a course run independently of it.
What if a scan was normal?
Expected. Dystonia is diagnosed clinically and imaging is used to exclude other causes rather than to confirm it, so a normal scan does not weaken the diagnosis. Imaging is still worth having in some presentations, because excluding a structural cause changes what treatment is safe to offer, and that is the question it answers.
Where exactly is the Henderson office?
1691 W. Horizon Ridge Parkway, Suite 100, Henderson NV 89012, just off the 215 Beltway, with parking on site. All six in-office studies are performed and interpreted there, so nothing is referred across to the Las Vegas office. Green Valley, Anthem, Whitney and Boulder City are generally closer to it than to West Flamingo Road.
Should I use the Henderson or the Las Vegas office?
Whichever is the shorter drive, since both are fully equipped and hold the same records. West Horizon Ridge Parkway generally suits Green Valley, Anthem and Boulder City; West Flamingo Road suits the west and southwest of the valley. If you can attend either, say so when booking, because availability differs between the two week to week.
How this page was sourced
Practice facts come from Clinical Neurology Specialists directly: that no surgery of any kind is performed, that implanted devices are programmed and followed up at both offices, that botulinum toxin is administered for clinical indications and no cosmetic injections are performed, and that rehabilitation therapies are coordinated rather than delivered on site. Clinical context is sourced to the organisations listed below.
No named medications, doses, stimulation parameters or response rates appear, because selection and adjustment are clinical decisions specific to the individual. Prevalence is described comparatively rather than numerically. No outcome is promised. Scope is adults 18 and older.
Change log
- 2026-07-28 — page published; clinical content reviewed.
- 2026-07-28 — last reviewed against AAN, AANEM and NINDS guidance; internal links and schema verified.
- Review cadence: quarterly, or sooner if guidance changes.
How to cite this page
Clinical Neurology Specialists. “Dystonia specialist Henderson.” Reviewed 2026-07-28. https://www.cnsnevada.com/conditions/parkinsons-tremor/dystonia-specialist-henderson/
References
- Parkinson's Foundation — patient information and care standards for Parkinson’s disease.
- National Institute of Neurological Disorders and Stroke — the reference catalogue of nervous-system disorders.
- American Academy of Neurology — clinical practice guidance.
This page is for general information about a Clinical Neurology Specialists office and is not medical advice, a diagnosis, or a treatment recommendation. It does not create a physician-patient relationship. Adults 18 and older. For an active stroke, a first-time or prolonged seizure, sudden severe headache, sudden weakness, sudden vision loss, or a head injury with loss of consciousness, call 911 or go to the nearest emergency department.