Focused ultrasound is used with MRI to precisely guide ultrasound beams to treat and ablate a small area deep within the brain.

The ultrasound waves pass through the brain and converge in an area called the thalamus, heating and creating a lesion that disrupts the cause of the tremor.

Focused ultrasound does require you to meet the following criteria:

• Official diagnosis of essential tremor or Parkinson’s disease
• At least 22 years old
• Under 300 pounds
• Able to go into an MRI machine without experiencing significant claustrophobia
• Tried and failed to respond adequately to both primidone and propranolol
• Undergo a complete head shave before the procedure

Please note that not all metal implants, including certain kinds of pacemakers, exclude patients from this procedure.

Focused ultrasound is a safe process for tremor treatment with few side effects:

• It doesn’t require incisions, implants or ongoing, long-term maintenance, so there is no risk of infection.
• The procedure precisely targets the area of the brain responsible for your tremor.
• Typically, you can receive the treatment and go home the same day.
• Focused ultrasound may potentially improve your hand tremors, providing you with a better quality of life.

While the treatment may improve your tremor, it’s important to understand that it doesn’t treat the underlying disease nor prevent its progression.

• Prior to treatment, you’ll need a specialized CT scan and potentially an MRI scan.
• You’ll be required to shave your head. Otherwise, air bubbles could get trapped in the hair, blocking the ultrasound waves and potentially causing skin burns.
• Right before treatment, a water-based gel is applied to your scalp as a conductive medium. Then, you wear a silicone cap to help the ultrasound transducer work properly.
• A standard stereotactic frame is placed on your head to ensure that it doesn’t move during treatment.
• You lay on the treatment bed and are placed inside the MRI scanner from the mid-torso up.
• You need to be awake during the entire procedure, which takes around 2.5 hours on average.

An important note: You’ll need to arrange for a ride home following the procedure, and you won’t be able to drive for at least two weeks afterward.

As of July 12, 2020, the MRI-guided focused ultrasound treatment for medication-refractory essential tremor is a Medicare-covered benefit in all 50 states, covered under Medicare Part B.

Other private health insurance plans cover focused ultrasound, but it’s always best to check with your provider and see if it is covered under your health plan.