Focused ultrasound can provide relief for hand tremors caused by essential tremor with no incision and no hospital stay.
That means it has fewer risks and an easier recovery time compared to surgical procedures for essential tremor, such as Deep Brain Stimulation, RF Thalamotomy, and Gamma Knife Surgery.
Most focused ultrasound patients have few side effects and go home the same day with immediate, lasting improvement in their hand tremors.
Nearly 10 million Americans are impacted by essential tremor, a condition that causes one or both hands to shake uncontrollably.
The condition can be debilitating, robbing patients of their ability to eat and drink, write, take care of themselves, and take part in favorite activities.
“We’re still trying to understand exactly where these tremors originate from. In many cases the tremors are hereditary, and can progress as you age to the point where it’s pretty debilitating,” said neurosurgeon Dr. Aaron Bond. “Many people think it is part of aging, and they have to just live with it, but that’s not true – there are treatments available.”
Regional One Health’s East Campus Imaging Center offers one of those treatments – focused ultrasound, a non-surgical procedure proven to provide immediate, lasting relief from hand tremors with low risk and few side effects. Focused ultrasound is available for qualifying patients who are 22 or older, have a confirmed diagnosis of essential tremor or tremor-dominant Parkinson’s, and whose tremor doesn’t respond to medication.
The procedure is an excellent option for patients who have reached the point where medications no longer work but who want to avoid the risks and recovery associated with surgery.
Dr. Bond explained how focused ultrasound works and how it compares to the other procedures, including Deep Brain Stimulation, RF Thalamotomy, and Gamma Knife Surgery.
Focused ultrasound uses safe ultrasound energy guided by MR imaging to treat the exact spot in the brain that is responsible for tremors.
During the procedure, patients must have their head completely shaved. They are fitted with a specialized helmet called an ultrasonic transducer that keeps their head still and circulates cool water. Both steps help ultrasound energy to pass easily through their skull.
Next, the patient lies on their back on a treatment table, and the treatment team performs an MRI to identify the exact spot in the brain to treat.
The patient will move in and out of the MRI several times over the course of about 2 hours as the team applies a series of treatment sonifications. During a sonification, ultrasound energy passes harmlessly through the skull and surrounding brain tissue to create a therapeutic ablation.
Patients are awake during the procedure and are asked to perform simple tasks, like drawing a spiral or touching the doctor’s finger, to make sure the treatment is working. They are also asked to report side effects, which can include dizziness or feeling like the room is spinning. Doctors can make real-time adjustments to improve efficacy and reduce side effects.
When the treatments sonifications are done, the patient is given another MRI and then taken to a recovery room for snacks and water. After a final assessment, they can go home.
For most patients, the treatment provides immediate, lasting tremor relief. Side effects are minor and short-lived, including dizziness, unsteadiness, and numbness or tingling in the fingers.
Dr. Bond said focused ultrasound has numerous advantages.
“It’s an outpatient procedure, so there’s no hospital stay. There are no incisions or implants, which means there is little risk of infection. There’s no ionizing radiation and no anesthesia. Complications are minimal, and recovery is typically easy,” he said.
“Most importantly, you go home with your tremors gone. There’s significant improvement in your quality of life.”
Those advantages make focused ultrasound attractive to patients who need a procedure for their tremor but want to minimize risk and recovery time associated with other options.
Deep Brain Stimulation, or DBS, is a surgical procedure that involves creating small holes in the skull to implant electrodes in the brain. It is proven to be effective, and doctors can adjust the device if a patient is experiencing side effects.
Radiofrequency Thalamotomy, or RF Thalamotomy, works based on the same theory as focused ultrasound – disrupting the spot in the brain that causes tremors. However, it also requires surgery to insert a probe into the brain.
Any surgical procedure carries risks such as infection or bleeding, as well as a recovery period.
Finally, Gamma Knife Surgery is non-invasive, but does use ionizing radiation to create the therapeutic lesion. Also, the lesion isn’t formed for a couple months, so results are not immediate and doctors can’t make adjustments based on patient feedback during the procedure.