Chapters Transcript Video Essential Tremor Treatment with HIFU Dr. Timothy Miller Essential tremor is a movement disorder that affects mainly the patient's ability to control movement in their hands. Prevalence is about 0.3% of the population, so about 1 out of 300 people deal with essential tremor. There is a hereditary component. Many patients describe a father, mother, or brother that has the condition, but there's not a direct inheritance, meaning if my father has the condition, I, I may not inherit that. It is what we call an action tremor, meaning when patients are performing an action, the tremor is exacerbated, and then at rest the tremor calms down. There is no necessarily early detection other than symptoms arising at a young age. It is a progressive disease, meaning that it gets worse over time during a patient's life. It is a benign condition, meaning that it's not life threatening, but it does interfere with quality of life, uh, ability to eat, drink, perform other activities. There are medical managements. There are a few drugs that are effective for calming down tremors. Some of them have some side effects that patients do not tolerate, which may make them candidates for further treatment such as deep brain stimulation or HIFU, high intensity focused ultrasound. High intensity focused ultrasound uses about 1000 different ultrasound waves all focused on one very small spot, and that area in the brain heats up during the ultrasound treatment and inactivates the neurons that are responsible for essential tremor. It is an outpatient procedure. We do it in an MRI scanner. It takes about. An hour these days we do hope to see instantaneous results after we complete the treatment, and the way that we know that we're achieving that is by evaluating the patient on the MRI scanner. We have them draw spirals, write their name, and perform a number of other tasks in real time and test the tremor as well as evaluate for potential side effects during the treatment. Side effects that we sort of expect are mild headaches, sometimes some coordination issues with the treated hand, and sometimes some balance issues. All of these side effects are typically temporary and resolve greater than 96% of the time within a year of treatment. Patients with essential tremor come to see us because we have a multidisciplinary team I work closely with. We have the most up to-date technology and we just have a, a wonderful group of both a research nurse coordinator, myself, and a number of other team members that have all performed all 85 of these treatments together and are very skilled and very experienced. Created by