Non-Invasive Treatment Stops Essential Tremor in Its Tracks

Imagine pouring yourself a cup of hot coffee with shaky hands. Or attempting to shave. Or even sign your name. Or drive. For the estimated 10 million Americans who suffer from essential tremor (ET), many daily tasks are impossible ― and sometimes downright dangerous.

Thanks to physicians at Marcus Neuroscience Institute at Boca Raton Regional Hospital, part of Baptist Health, many patients with ET who have not responded to medications are now able to take advantage of a new non-invasive treatment available at the Institute. The treatment has been used with excellent results at Baptist Health Miami Neuroscience Institute.

Timothy Miller, M.D., a neurosurgeon and director of functional neurosurgery at Marcus Neuroscience Institute, part of Baptist Health

High-intensity focused ultrasound (HiFU) is an incisionless, painless outpatient procedure that sends more than 1,000 beams of ultrasound through the skull to target and destroy lesions that are disrupting the brain’s normal circuits. The treatment is done in one session.

“Essential tremor is a miscommunication between different parts of the brain,” explains Timothy Miller, M.D., a neurosurgeon and director of functional neurosurgery at Marcus Neuroscience Institute. “With HiFU, sound waves destroy the cells causing the tremor. Results are immediate, improving the quality of life for our patients right away.”

ET is a progressive neurological condition that most often affects the hands. Some people also experience uncontrolled shaking of the head, their voice or their legs. The cause of the movement disorder is unknown, but upwards of half of all patients report that they had a parent with the condition.

While it’s not life-threatening, ET is often extremely disabling. It is also commonly misdiagnosed, and while many people believe it’s a typical sign of aging and that there’s nothing that can be done to help, doctors say they are wrong on both counts.

“ET is more common as we age, but it can occur at any age,” Dr. Miller says. “ET also progressively worsens over time, but treatment can diminish or eliminate tremor.”

The U.S. Food and Drug Administration approved HiFU for essential tremor in 2016 and just recently approved its use in patients who suffer from tremors on both sides of their body, meaning that it can be performed twice ― separately for each side of the body. HiFU is also used to treat other conditions and diseases.

The benefits of HiFU over traditional surgery include little to no risk of infection, no hospitalization, no general anesthesia and no invasive burr holes into the skull or implants.

Before the procedure, the patient’s head is shaved and they are asked to draw and/or write. They are moved into an MRI machine, where a frame holds their head in place. Throughout the procedure, experts are at the patient’s side, checking that things are proceeding well. Patients may be asked to move a certain way and repeat the drawing exercise to see the tremor’s improvement.

Most patients experience no side effects, but some may have temporary headaches, nausea or tingling of the lips or fingers.

“HiFU is a life-changing option for those whose lives have been disrupted by a debilitating disorder,” Dr. Miller says. “It’s a win for our patients.”