Essential Tremor Ultrasound

August 10, 2018

The FDA recently approved focused ultrasound to treat essential tremor. Ultrasound is a non-surgical method of treatment for essential tremor. The noninvasive treatment called Neuravive MRI-guided focused Ultrasound focuses non tremors that do not respond to medication. The results are comparable or better than those of Deep Brain Stimulation, which used to be a common surgery, along with thalamotomy. Success from the ultrasound treatments is immediately noticed, and recovery is rapid. 

There are many advantages to using the ultrasound technique over other surgery related treatments. These advantages include the fact that it is non-invasive, and there are no incisions and no holes in the skull. The real-time MRI allows planning, guidance, and a better and more controlled monitoring environment. The procedure is outpatient, and there is no exposure to radiation. The risk of infection is diminished because there are no surgical wounds. The ultrasounds provide lasting control of tremor without medication. Lastly, there is very low risk of persistent side effects. 

Other treatments for essential tremor include medication by beta-blockers, thalamotomy surgery, and DBS. All of these have severe risk for side-effects and other complications.
They also tend to be a more temporary fix, and the surgical methods seem to have a lower success rate than the ultrasound treatment does. Success for ultrasound at the one month mark is about 91 percent, which is lower than the 100 percent rate for a thalamotomy, but after one year, the chance of side effects returning is a 4 percent with ultrasound but is 11 percent with a thalamotomy. So, lasting effects from ultrasound are real and measurable. 

Ultrasound is a form of energy that passes through tissue without harming it. It doesn't involve any sort of radiation or surgery, which is a big benefit. Because of brain mapping that has been done with lots of time and research beforehand, they are able to focus thousands of beams of ultrasound energy all pinpointed to one very small area of the brain, the thalamus, where the signals for tremors are made. As the ultrasound energy destroys the surrounding area, the tremor signals become interrupted. When the treatment is over, the tremors are not able to continue because the signals have become destroyed or at least interrupted. 

During ultrasound treatment, the patient lies on the bed that slides into the MRI scanner. The patient wears a helmet to keep their head still, and contains the ultrasound delivery system. This system does not require any anesthesia, and keeps the patient fully awake. This is also beneficial to those that may have negative side effects when under anesthetic. There is no pain, and the procedure continues without any sort of sedative or probes. 

Overall, ultrasound therapy is a great option for those suffering from essential tremor who don’t want to experience the recovery times or risks that are involved with traditional surgery techniques. The treatment is fairly new, but ask your medical professional if something like ultrasound treatment would benefit you and your tremor symptoms. 


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