Focused Ultrasound for Essential Tremor

Parkinson’s disease is a movement disorder that severely impacts the lives of those living with it. The disease gradually gets worse with time, and while there is no cure currently, there are treatments that can help people take back control. This Parkinson’s Awareness Month, we want to talk about Focused Ultrasound for hand tremors, and how it can help those patients.

What is Focused Ultrasound (FUS)?

Focused Ultrasound allows neurosurgeons to treat deep in the brain without having surgery. Sound waves pass safely through a patient’s skull to heat and precisely destroy the target cells in the thalamus responsible for the tremor, thus providing relief. This outpatient procedure is incisionless and does not require anesthesia.

What are the benefits?

The largest benefit is the relief of hand tremors, which is especially significant to those patients with Parkinson’s. For instance, among success stories, patients who have had both hands treated are able to do things they haven’t done in years—hold a cup of coffee, play golf, and easily apply cosmetics—all medication-free.

What are the risks?

The largest risk and most common side-effect is gait instability—feeling unbalanced while walking—after the procedure. This typically resolves itself within two weeks. However, rare instances have been reported where it has lasted longer or been permanent. As with any procedure, talk to your physician about the benefits and risks to make an informed decision about your treatment plan.

Who qualifies for FUS?

Patients with essential tremors of the hand and patients with tremor-dominant Parkinson’s disease qualify with these caveats:

• You must have tried medications to manage your tremor first without success.
• Your tremor impacts your daily activities and life.

How should patients prepare for the procedure?

You will have a consultation with a neurosurgeon and undergo a CT head scan to determine your qualification. Additional follow-up visits will be discussed if needed. You should also be aware that your head will be shaved at the hospital on the day of the procedure. This is because:

• Ultrasound waves do not travel well through the air. This treatment uses water as a conductive medium (like a gel used when having an abdominal ultrasound). The smooth-shaven scalp and a silicone cap enable a tight interface with the ultrasound transducer.
• Air bubbles could get trapped in the hair, interfering with the ultrasound waves, and causing incomplete sonication.

For more information about what to expect during the procedure and how to prepare, see the flyer from the Sentara Comprehensive Movement Disorders Program on Focused Ultrasound to Treat Hand Tremors.

What’s recovery like?

Recovery depends on your individual health status. However, relatively healthy patients who can walk independently prior to the procedure typically have a quick recovery. It is advised that you do not make plans for after the procedure, and instead take the next few days to rest and recover. The doctor will prescribe medications to help speed up the recovery process and alleviate any swelling near the sonicated site.

Questions to ask your physician

It’s always a good idea to discuss treatments and procedures with your physician, as they will be able to help determine the best course of action with you. Here are some questions you can ask as you are considering options to relieve your tremors:

• Have you heard of Focused Ultrasound for hand tremors?
• Do you feel like I would be a good candidate for MRI-guided FUS?
• Can I try medication to alleviate my hand tremor?
• Is there anything that would prevent me from having an MRI?

Make an appointment and learn more

For more information about Focused Ultrasound and to request an appointment with a Sentara physician, visit our Focused Ultrasound to Treat Hand Tremors page.