Essential Tremor

Essential tremor (ET) can make daily activities such as eating, drinking and writing difficult. At OU Health in Oklahoma City, patients may find incisionless relief by using focused ultrasound, an advanced treatment that can help reduce tremors and improve quality of life.

What Causes Essential Tremor?

The inherited variety of essential tremor, known as familial tremor, is an autosomal dominant disorder. This means that an altered gene from just one parent is enough to pass on the condition. Anyone who has a parent with an altered gene for essential tremor has a 50% chance of developing the condition. About half of all people with essential tremor appear to have an altered gene. It is not clear what causes ET in individuals who do not have familial tremor, but the condition is more common in people aged 40 and older.

What are the Symptoms of Essential Tremor?

Symptoms of essential tremor may include:

• Shaking in the hands, especially during movement or daily tasks
• Head shaking that looks like a “yes” or “no” motion
• Tremors that may spread to the voice, arms, face, or other parts of the body over time

Essential tremor is sometimes confused with Parkinson’s disease, but the conditions are different.

Focused Ultrasound Treatment

Focused ultrasound (FUS) is an FDA-approved, non-invasive procedure that can reduce tremors without surgery, incisions, or implanted devices. Many patients experience improvement during or shortly after the procedure.

Focused ultrasound uses targeted sound waves to treat the specific area of the brain responsible for tremors. The treatment is guided by magnetic resonance imaging so the sound waves pass safely through the skull and focus only on the intended area. Focused ultrasound is FDA approved for the treatment of essential tremor.

Because there are no surgical cuts or implants, the risk of infection is minimal. The procedure is often performed on an outpatient basis, and many patients return to normal activities within days. OU Health is proud to be the first in Oklahoma offer focused ultrasound for essential tremor.

Am I a Candidate for Focused Ultrasound Treatment?

To determine if you are a candidate, our team will evaluate your overall health and the severity of your tremor. If your essential tremor is unresponsive to medications, you may benefit from focused ultrasound treatment. Patients will undergo a computed tomography (CT) scan as part of the evaluation. If you are a candidate, you will work closely with your OU Health care team to plan and prepare for treatment.

What Are the Benefits of Focused Ultrasound?

Focused ultrasound precisely targets only the areas of the brain responsible for tremors. The procedure allows sound waves to pass safely through the skull with no incisions or implants and reduces risk of infection.

Many patients report improvement during the procedure itself. The treatment is often performed on an outpatient basis, and you can expect to resume normal activities within days.

What Happens Before, During and After the Procedure?

Before Focused Ultrasound Treatment

Patients who are evaluated as candidates for focused ultrasound will meet with their care team to review the treatment plan and timeline. Preparation is minimal, but patients will need a cleanly shaven head to allow sound waves to pass effectively. A local numbing medication is applied, followed by injecting numbing medications to improve your comfort while the head frame is applied to keep the head steady during treatment.

During Focused Ultrasound Treatment

Along with an MRI, your doctor will begin by first applying light doses of ultrasound energy to identify the precise spot in the brain for treatment. After each application of energy, called a sonication, you will be asked to perform specific tasks such as touching your nose to evaluate your tremor improvement.

The treating physician will then gradually increase the energy to create a small lesion, usually resulting in improvement of hand tremors. Many patients report immediate improvements during the treatment itself. Your heart rate, blood pressure and blood oxygen levels will be monitored throughout the treatment which typically lasts about two and a half hours.

After Focused Ultrasound Treatment

After treatment, you will rest in our recovery area. Your physician will let you know when you can go home and when you will need to return for a follow-up care. Most patients return to normal activities within a few days.

Your Essential Tremor Care Team

Your OU Health essential tremor team involves highly trained neurosurgeons with specialty education in functional and epilepsy surgery and significant experience in treating movement disorders. They collaborate with a variety of other medical specialists, as needed, to create your individualized treatment plan.