Focused Ultrasound

What are Essential Tremors?

Essential Tremor is the most common type of movement disorder that causes involuntary, rhythmic shaking of the hands, head, arms, legs or voice. Shaking can occur with simple tasks such as writing, drinking from a glass, or tying shoelaces. Essential tremor usually runs in families.

What is Focused Ultrasound?

Focused Ultrasound is a non-invasive procedure using MRI and ultrasound to make a very small lesion in the ventral intermediate nucleus of the thalamus, the area of the brain responsible for the tremor.

Benefits of Focused Ultrasound

• Immediate tremor improvement
• Improvement in performing daily activities
• Improvement in quality of life
• Outpatient procedure, typically taking 3-4 hours.
• No incisions means decreased risk for infection
• There is no anesthesia given, patients must be awake and able to respond to the Neurosurgeon during the procedure.

When Should I Consider Focused Ultrasound?

Focused ultrasound is an incisionless procedure approved by the FDA for the treatment of essential tremor. The treatment uses high-frequency, high-energy sound waves to target and destroy a very small area of tissue deep within the thalamus, an area of the brain responsible for the tremor. This procedure is discussed with patients that have tried and failed medications due to side effects or ineffectiveness of the medication, and are not a candidate for deep brain stimulation. The procedure can only be done unilaterally, or on one side, typically on the dominant side or the side with the more prominent tremor. Patients also must complete a preoperative head CT scan to determine if skull density is sufficient to support sound transmission.

Interested patients will have the opportunity to have a virtual meet and greet with the physicians before scheduling the procedure.

Am I A Candidate for Focused Ultrasound?

Good Candidates for Focused Ultrasound Include the Following:

• You have severe to moderate essential tremors that limit your daily activities such as the ability to eat, drink, or write, among others.
• You are over the age 22
• You have tried at least two medications for tremors, one being either Primidone or Propranolol
• You have medication side effects from tremor medications, such as drowsiness or depression, or the medications you have tried for your tremor do not work to control your shaking.
• You have severe anxiety about conventional surgery for tremor

You Are Not a Candidate for Focused Ultrasound if:

• You cannot stop your blood thinning medications
• You cannot have an MRI
• You exclusively have head or voice tremor
• You have had a stroke in the thalamus (portion of the brain responsible for the tremor)
• You have Multiple Sclerosis
• You have unstable cardiac disease
• You are pregnant