Focused Ultrasound for Essential Tremor

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Uncontrollable shaking from essential tremor can force you to stop doing the things you love, but it doesn’t have to. If medications fail to relieve the symptoms of your movement disorder, you have other options.

Focused ultrasound treats essential tremor by targeting and destroying a small patch of brain tissue responsible for essential tremor. The procedure does not involve cutting into your body, so recovery is quick and mostly without discomfort.

Relief From Essential Tremor

UVA is the first program in the U.S. to treat essential tremor using focused ultrasound. Just one treatment is often all it takes to get lasting relief. View focused ultrasound transcript.

About Focused Ultrasound for Essential Tremor
  • Not everyone with essential tremor is eligible for focused ultrasound. You may not be eligible for focused ultrasound if you have a pacemaker, kidney disease or can’t have an MRI. However, our team can help you find an alternative treatment, including deep brain stimulation.
  • The FDA approved focused ultrasound for essential tremor in July 2016. This treatment is not currently covered by insurance. We're working with insurance companies to cover this procedure in the future.
  • Focused ultrasound is available for other medical conditions, including uterine fibroids, Parkinson's disease and to stop the spread of certain cancers (bone metastases). 

The Focused Ultrasound Procedure

One focused ultrasound treatment is usually all it takes to significantly reduce tremors and help you return to everyday activities. 

What to expect on the day of treatment:

  • You lie on a table and we secure your head in a helmet-like device, called a transducer.
  • The table rolls you into the magnetic resonance imaging (MRI) machine, which is a large hollow tube. If you're afraid of confined spaces, we can give you medication to help you relax.
  • The MRI scanner produces high-resolution images of your brain, which helps us pinpoint the area responsible for the tremor, called the thalamus.
  • The transducer delivers over 1,000 beams of sound waves to the thalamus. Individual beams pass through the skull without any disruption. Where the beams cross, they create heat (thermal ablation) that destroys brain tissue at the focal point.
  • We monitor the location and intensity of your treatment. We may also ask you to perform simple tasks, such as moving your hands or fingers, during treatment. These safety checks help us ensure the success of your treatment.
  • The effects of the procedure are immediate. You can expect to get up and move right after your procedure.
  • You may be able to go home the same day, or you may need to spend one night in the hospital.

How Does Focused Ultrasound Work?

  • Focused ultrasound disrupts the brain activity responsible for the tremors while protecting normal, healthy tissue, by:
    • Using MRI to accurately target brain tissue responsible for the tremors
    • Delivering concentrated beams of ultrasound energy to the treatment area
    • Disrupting the abnormal electrical activity in the brain and relieve your symptoms

What Are the Side Effects of Focused Ultrasound Treatment?

  • Sensory disturbance: Patients sometime feel numbness or tingling in their fingertips or lips on the side of the body getting treated. The sensations tend to be very mild and temporary. Very few patients describe these feelings as uncomfortable. In 10-15% of cases, the sensations may be permanent.
  • Gait disturbance or imbalance: Patients commonly feel unsteady on their feet after the procedure. Typically, this only lasts through the 1st or 2nd week after the procedure. In clinical studies, permanent unsteadiness was reported in up to 10% of the patients.
  • Minor side effects, such as headache, pain and dizziness: Some patients may feel warmth, pain or dizziness lasting only for a few seconds during the procedure. These effects are not felt after the procedure.
  • Major side effects, such as stroke, infection or seizures: The risk for experiencing these side effects is very low.

Do I Qualify for a Focused Ultrasound Thalamotomy?

  • Focused ultrasound thalamotomy is a special type of focused ultrasound procedure that can be very effective for managing essential tremor. Your care team will evaluate you as a potential candidate for this procedure. You are a good candidate if:
    • You have a confirmed diagnosis
    • Your tremors have not gotten better with medications (such as propranolol or primidone)
    • Your tremors are severe enough to consider a surgical procedure 
    • Your condition limits your ability to perform daily activities  
  • If you are a good candidate for focused ultrasound thalamotomy, you'll also need to undergo a special CT scan as part of your evaluation. Because of this, you may not be eligible for focused ultrasound thalamotomy if you can't have a CT scan because you have a pacemaker or other implanted device.
  • If you are prone to anxiety or claustrophobia, you may have trouble tolerating the 2-3 hour procedure.

What is the Likelihood of My Tremors Returning?

  • There is always a chance that the focused ultrasound thalamotomy procedure might not work or that the effects will wear off with time. We are unable to guarantee the result or provide refunds for the procedure if it is ineffective. 

View answers to frequently asked questions about focused ultrasound.