HCA Virginia - April 15, 2021

Focused ultrasound for essential tremor

Typing, eating, buttoning a shirt—these everyday tasks can be exceptionally challenging with essential tremor. Essential tremor can cause uncontrollable shaking, creating a struggle to perform day-to-day activities.

If you’re living with essential tremor, focused ultrasound treatment may be an option to improve your tremors. Learn more about essential tremor and the treatment options available. 

What is essential tremor?

Essential tremor is a neurological condition that results in tremors in the body. It typically affects the upper limbs, most commonly the hands and arms. It can also involve the head, voice, legs, or torso. Essential tremor usually occurs in people over age 40 and can worsen over time.

“The tremors tend to occur during activity, so they interfere with common tasks such as writing, holding a plate or beverage, and with personal care like putting on makeup or brushing teeth,” said Mathew Boyce, MD, movement disorder neurologist and medical director of the Deep Brain Stimulation program at Johnston-Willis Hospital. “They can also impact tasks that require fine motor skills and make it difficult for someone to continue their livelihood. It can vary from being embarrassing while eating with friends to making it almost impossible to feed oneself.” 

Essential tremor is commonly managed with medication but is not curable. For those who have not found relief with medication, focused ultrasound can provide immediate improvement.  

What is focused ultrasound?

“Focused ultrasound is a non-invasive procedure,” said Dr. Boyce. “Instead of using scalpels and knives, we’re using energy—the energy from sound waves.”

Focused ultrasound uses sound waves to target the area of the brain causing the tremor. The treatment uses magnetic resonance imaging (MRI) to accurately guide the heat generated from the sound waves. This allows the care team to target and treat the specific area of the brain while protecting the surrounding areas.

The patient’s head is numbed and positioned with a head frame to prevent movement. The patient is awake during the treatment, so the patient and care team can communicate and test the progress.  

Benefits of focused ultrasound

Focused ultrasound treatment is an outpatient procedure, and the patient returns home the same day. There are no incisions or implants. Patients can return to normal activities within a few days.

For most patients, the biggest benefit of focused ultrasound is the immediate improvement in their tremors. Within hours, patients can hold their hand still enough to drink or eat without spilling and write clearly.

“It’s really amazing to be able to start the day dealing with a bothersome symptom and go through a procedure like focused ultrasound that doesn’t involve any incisions. And at the end of the day, the tremor is so much better,” said Dr. Boyce. “It is so rewarding to see someone smile enjoying a meal post-procedure and know that their quality of life will be improved.”

Side effects of focused ultrasound are mild, says Dr. Boyce. During the procedure, some patients may experience headaches or nausea. A small percentage may have temporary symptoms afterward, such as:

  • Balance difficulty
  • Tingling in the treated side’s fingertips or lips
  • Speech or swallowing difficulty

Focused ultrasound at Johnston-Willis Hospital

The neurology and movement disorders specialists at Johnston-Willis Hospital are experts in treating tremors. Johnston-Willis Hospital is the only hospital in Richmond that offers focused ultrasound and one of few in the country that also performs deep brain stimulation and Gamma Knife treatment for tremors. This expertise allows the care team to speak to the benefits of all treatments and customize care for the individual.

If your essential tremor affects your quality of life, contact a nurse navigator [link to: https://hcavirginia.com/campaigns/johnston-willis-focused-ultrasound?dotcache=refresh#form] or call (804) 483-5711 to learn more about treatment options. Virtual appointments are available.