You may be a good candidate for focused ultrasound treatment if you have tremor that doesn’t respond to medications, and:
- You have a confirmed diagnosis of essential tremor and you’re at least 22 years old
- You have a confirmed diagnosis of Parkinson’s disease and you’re at least 30 years old
There are a few reasons focused ultrasound treatment may not be suitable for you. For example, if you have certain heart conditions or a metal implant such as a pacemaker or neurostimulator that’s not compatible with MRI.
At Atrium Health Wake Forest Baptist, our experts provide a comprehensive evaluation to determine if you’re eligible for focused ultrasound. And if you’re not, our team will help you find other treatment options.
Specialists at our Movement Disorders Center offer exceptional care for all types of movement disorders. However, focused ultrasound is only FDA-approved to treat hand tremor caused by essential tremor and tremor-dominant Parkinson’s disease.
The first step of focused ultrasound treatment is a consultation with a neurologist specializing in movement disorders. The doctor will provide a comprehensive evaluation to determine if focused ultrasound is an option for you. If the neurologist determines you are a suitable candidate, you will be examined by a neurosurgeon and a neuropsychologist who are part of the interdisciplinary team. The interdisciplinary team will discuss your case and determine your candidacy for the procedure.
During your evaluation, you will be asked questions about your overall health, including your tremor symptoms. You will also need to have a CT scan to confirm your eligibility for focused ultrasound treatment. All of your appointments will be coordinated by our movement disorders coordinator.
First, it’s important to know that your care team will make sure you’re fully prepared for treatment. If you have questions about the process, reach out to your doctor or the focused ultrasound program coordinator. In general, here’s what you can expect on the day of treatment.
Before treatment begins, we’ll shave and clean your head. You will be given a local numbing medication and may be given additional medication to help keep you comfortable. You will put on a head frame to help you stay still and then move into the MRI bed. Your heart rate, blood pressure and blood oxygen levels will be monitored throughout the treatment, and you will be awake and communicating with the treatment team.
During the treatment, you will lie in an MRI scanner with your head fitted into a water-filled helmet. First, we’ll take a series of MRI images for treatment planning. The physician will apply light doses of ultrasound energy to help identify the precise spot in the brain for treatment by assessing temporary tremor improvement and any potential side effects. Cool water will circulate in the helmet around the top of your head, and you will be kept warm in case you get chilled. You will also be given a stop button to indicate to the physician that you want to stop the procedure for any reason.
Focused ultrasound energy waves will pass through the helmet to the targeted spot in your brain. After each application of energy, called a sonication, you will be asked to perform specific tasks to evaluate your tremor improvement. Tasks may include touching your nose with your finger and/or drawing spirals. Though results vary, you should start to notice improvement to your symptoms during treatment. On average, time on the treatment table lasts about 2.5 hours.
Ultrasound waves don’t travel through hair very well. To make sure nothing is blocking the waves during your treatment, your head will be shaved before the procedure begins.
We need to communicate with you throughout your focused ultrasound treatment. You’ll be asked to do tasks, such as drawing spirals, so that your doctor can evaluate the improvement of your tremor. We’ll also ask questions about how you’re feeling and check for any potential side effects you may experience during treatment.
After treatment, the frame will be removed from your head and you will go to the recovery room. Your doctor will let you know when you can go home and when you may need to return for a follow-up visit. Your treatment team will also give you instructions for your recovery. You should be able to return to normal activities within a few days.
The side effects of focused ultrasound treatment are typically minor and temporary. But like any medical procedure, there are possible risks.
With focused ultrasound, you may experience side effects such as:
- Numbness or tingling
- Balance problems
- Problems with speech or swallowing
These side effects could start several days or weeks after treatment.
Focused ultrasound is not a cure for essential tremor or Parkinson’s disease. It’s possible, but unlikely, that you will not experience improvement to your tremor symptoms after treatment. There’s also a chance that your symptoms will improve but come back months or years later.
Before receiving focused ultrasound treatment, be sure to talk to your doctor about the possible risks and side effects.
You should notice improvement to your hand tremor immediately after your focused ultrasound procedure.
Focused ultrasound can treat one side of your brain at a time. Many patients choose to start with the side that their dominant hand is on. Depending on your health, we may be able to treat the other side of your brain at least 9 months after your first side is treated.
Studies show that most patients continue to have improved symptoms 3 years after treatment. However, it’s possible that your tremors will return months or years after treatment, or that your tremor may not improve at all.
We are not able to guarantee the results you will experience from the procedure. But if you have concerns about your tremor symptoms returning, we encourage you to bring these concerns up with your doctor.
If you live more than 2 hours away from Winston-Salem, NC, we recommend staying locally the night of your procedure. Our program coordinator can help you find local accommodations. You can also find out more about affordable lodging options here.
Insurance coverage depends on your individual condition and your health insurance plan. It’s best to contact your health insurance provider directly to find out if focused ultrasound treatment is covered.
To request a consultation, contact our neurosurgery team at 336-716-4081. Or, ask your doctor to send a referral to the neurosurgery department at Atrium Health Wake Forest Baptist.