CLEVELAND, Ohio (Ivanhoe Newswire) — Essential tremors impact ten million Americans, typically causing one or both hands to shake and interfering with simple tasks like writing or drinking from a cup. Treatments include medication or surgical deep brain stimulation but are not options for everyone. A newly FDA- approved therapy is helping patients make rapid improvements.
Seventy-four-year-old Bill Purcell’s tremors started five years ago. It got so bad that he couldn’t even enjoy his coffee without spills.
Purcell said, “My wife didn’t want me to carry a cup of coffee from the coffee pot to the table anymore.”
Medication wasn’t working, and he wasn’t a candidate for deep brain stimulation. So, Purcell became one of the first patients to undergo a new non-invasive treatment at the Cleveland Clinic.
Sean Nagel, MD, Staff Neurosurgeon at the Cleveland Clinic said, “The focused ultrasound allows the physicians to target a very specific area of the brain. And as you slowly increase the energy over time, you can see the warming or the heating of the tissue within the brain itself.”
The MRI-guided ultrasound creates a lesion on the part of the brain that causes tremors, and patients can be tested for progress after each session. Purcell had immediate improvement after treatment.
Dr. Nagel said, “We were able to give him a cup of coffee, which for the first time in several years he was able to drink without spilling any.”
Purcell has regained the ability to write and his hand no longer shakes. But more importantly, he has accomplished his goal:
“My goal was to get out of bed and drink coffee without spilling. I did that so my day was a success,” Purcell shared.
Doctor Nagel says the therapy is also approved for tremors related to Parkinson’s disease. Doctors are currently only using the ultrasound on one side of the brain at a time. Long-term results are not available yet, but the procedure is covered by insurance.
Contributors to this news report include: Hayley Hudson, Producer; Cyndy McGrath, Supervising Producer; Robert Walko, Editor.
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TOPIC: FOCUSED ULTRASOUND TRIUMPHS OVER TREMORS
REPORT: MB #4580
BACKGROUND: Essential tremor (ET) is a progressive, neurological disease characterized by tremor, most often of the hands or arms. A tremor is an involuntary, rhythmic movement of a body part. Tremor may be seen as involuntary shaking or trembling of the affected area. In individuals with ET, other motor symptoms may be present including an unsteady manner of walking due to an inability to coordinate voluntary movements. In some cases, affected individuals may also develop a variety of non-motor symptoms including cognitive impairment, depression or anxiety. ET can occur in childhood or adulthood. The exact underlying cause of ET is not fully understood.
TREATMENT: Deep brain stimulation involves implanting electrodes within certain areas of the brain. These electrodes produce electrical impulses that regulate abnormal impulses. The electrical impulses can also affect certain cells and chemicals within the brain. The amount of stimulation in deep brain stimulation is controlled by a pacemaker-like device placed under the skin in the upper chest. A wire that travels under the skin connects this device to the electrodes in the brain. Although deep brain stimulation is minimally invasive and considered safe, any type of surgery has the risk of complications. Also, the brain stimulation itself can cause side effects. Deep brain stimulation involves creating small holes in the skull to implant the electrodes, and surgery to implant the device that contains the batteries under the skin in the chest.
FOCUSED ULTRASOUND: Sean Nagel, MD, Staff Neurosurgeon at the Cleveland Clinic is using focused ultrasound to treat some patients’ essential tremors. He said, “This MRI guided focused ultrasound is an exciting new therapy for patients with essential tremor. The way it works is the ultrasound is coupled to the MRI and then a small frame is applied to the head and then by heating up areas within the brain, you can measure that heating with the MRI itself to help verify the location of the treatment.” Results are still being monitored. Dr. Nagel says, “While we expect this to be an important device in the treatment of patients with tremor and Parkinson’s tremor, the long-term data is still unknown. There is a chance that in some patients the tremor could recur. In which case, they, you know, we’re not exactly clear if they’ll be eligible to repeat the treatment.”
(Source: Sean Nagel, MD)
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