Focused Ultrasound for Essential Tremor & Tremor-Dominant Parkinson’s Disease

Incisionless outpatient procedure

Focused Ultrasound is an incisionless, anesthesia free treatment option for those living with essential tremor or tremor dominant Parkinson’s disease. With no incisions or implants, this safe and effective procedure uses thermal ablation under MR guidance to immediately improve tremor, quality of life, and functional disability. This innovative treatment is now available at Hoag, offering specialized and comprehensive care right here in Orange County.

Focused Ultrasound (FUS) is an incisionless and safe treatment for people with medication refractory Essential Tremor or tremor dominant Parkinson’s disease (TDPD) where it is offered for unilateral tremor treatment. Focused ultrasound uses sound waves under the guidance of MR imaging, to create lesions in the brain to stop tremor. The sound waves are focused on a cluster of cells in the brain, for example the VENTRALIS Intermediate Nuceus (VIM) for patients with Essential Tremor. The temperature at the target rises high enough to create a small ablation or burn, interrupting the electrical circuits that cause tremor and providing a therapeutic effect.

FUS is FDA approved to treat bilateral Essential Tremor, with 9 months between each procedure. It is FDA approved to treat unilateral TDPD.

Pre-Treatment

After consultation with your neurologist or a treating neurosurgeon you will need to undergo a separate evaluation of your tremor. A CT scan of your brain is needed to determine if focused ultrasound is right for you. Sometimes the doctor performing the treatment will also order an MRI.

Preparation

The patient will need to arrive with a freshly shaven head in order to ensure there is no interference with the sound waves. A local numbing medication will be applied, as well as a headframe to ensure your head remains still during treatment. Medications are given in the event of nausea or headache .

During Treatment

The procedure takes place in an outpatient MRI, and typically lasts between 2-3 hours. No anesthesia or sedation is required, and patients are awake throughout the procedure to ensure immediate feedback and tremor assessment A series of MRI images are taken to plan according to your specific anatomy. The treating neurosurgeon will deliver a low dose of ultrasound energy to define the precise spot in the brain for treatment. Between applications of energy, the neurosurgeon may evaluate improvements in your tremor symptoms. Gradually, the energy will increase to create a small lesion to treat the tremors.

After Treatment

The headframe is removed and you will be discharged home. You will need to have a post procedure MRI the next day and follow up with your neurologist.

Experience You Can Trust

• Our Movement Disorders Program team offers the latest technological innovations to ensure customized and safe treatment options for our patients.

• Our neurosurgeons are board certified, with experience in surgical and non-surgical treatment options such as Deep Brain Stimulation Surgery and Focused Ultrasound.

Supportive Care Team

• Hoag offers the services of a Nurse Navigator and program coordinator, Nurse Practitioners, social worker services, physical, occupational and speech therapy as well as imaging technology. This interdisciplinary approach ensures an individualized care plan is created for you.

• Each team member is focused on providing the best, compassionate care for you and will walk you through every step of the way. Your Nurse Navigator will guide you through the process of FUS treatment and is available should you have any questions.