Groundbreaking Procedure Improves Essential Tremor

MemorialCare Neuroscience Institute

If you experience this, you may have an essential tremor. Essential tremor is the most common movement disorder. It primarily occurs in people who are ages 40 and older.

This neurodegenerative disease is caused by irregular electrical signals in the thalamus, the brain’s relay system for motor and sensory signals. Erratic signals cause involuntary rhythmic shaking of the head, the voice, and most often in the hands.

“Essential tremor can significantly impact the ability to perform everyday activities,” said Devin K. Binder, M.D., the medical director of the MemorialCare Neuroscience Institute at Orange Coast Medical Center.

“Some people live with it for years, even decades,” Dr. Binder said. “Mild to moderate tremor can be treated with medicine, but as it gets more severe, it can be disabling. Essential tremors can make writing, eating, drinking, and other tasks needing fine motor skills extremely difficult.”

Treatment for severe cases has involved a process called deep brain stimulation, requiring surgery to place a regulating electrical device in the brain.

There is now a less invasive procedure to treat severe essential tremor called MR-Guided Focused Ultrasound (MRgFUS), and Orange Coast Medical Center is one of just two hospitals in Southern California offering this advanced treatment.

An MRI that produces high-quality images of the patient’s anatomy in real time is combined with specialized ultrasound technology that sends sound waves to a tiny location in the brain.

The first procedure performed at the MemorialCare Neuroscience Institute at Orange Coast Medical Center was in November 2020.

To date, Dr. Binder has performed more than 100 procedures — more than any other neurosurgeon on the West Coast.

“The process takes about an hour and a half,” explained Dr. Binder. “The patient is awake and participates in active tremor testing during the procedure.”

The focused ultrasound system precisely pinpoints a pea-sized target in the thalamus of the brain and sends hundreds of beams to it in several short blasts. The lesion created by the ultrasound eliminates the erratic signals responsible for the tremor.

“We offer this treatment for people with moderate to severe tremor,” Dr. Binder noted. “Some side effects may include tingling, numbness and imbalance — which are all temporary.”

Published studies have shown that MR-Guided Focused Ultrasound treatment remains effective for at least five years.

You reach for a cup to pour yourself some coffee, but your hand starts shaking so hard it spills all over the counter. Now imagine that every time you try to use your hands, they start to shake.

“It has really taken off,” Dr. Binder said. “We are so pleased to be able to offer this life changing treatment at MemorialCare Orange Coast Medical Center.”