What is MR Focused Ultrasound?

MR focused ultrasound is a minimally invasive procedure for the treatment of Essential Tremor and Parkinson’s disease related tremors. It uses high-intensity ultrasound energy, guided by magnetic resonance imaging (MRI) to heat an exceedingly small, targeted area of the brain treating the tremor. This procedure does not involve any significant radiation.

Prior to the Procedure

  • A video or in-person consultation will be arranged with the neurosurgeon. Patients are educated about the procedure by the nurse practitioner. During this session, patients and family members will have the opportunity to ask questions.
  • CT Scan and MRI of the brain would be ordered.
  • Instructions will be given to discontinue Essential Tremor medications the night before the procedure, except for Propranolol which should not be discontinued.
  • If you are on a blood thinner you will be advised to stop taking it two days before the procedure with approval of your prescribing doctor.
  • Patients are advised not to eat or drink anything after midnight before the procedure.

The Day of the Procedure

  • This is an outpatient procedure. You will be assigned a private suite and a very experienced nurse will be with you throughout the procedure. Your family member will be updated during the day of treatment.
  • An IV will be placed and you will receive an antibiotic, nausea medication, and any other necessary medications.
  • After the completion of the frame placement patients are taken to the MRI Suite. There a silicon membrane will be placed on your head that will circulate cool water. This will minimize potential heating near the scalp.
  • You will lie flat on your back on a dedicated bed in the MRI suite. If you have difficulty lying flat, please inform your neurosurgeon during the initial consultation. You must be awake during the process and be able to communicate with the treatment team.The procedure will be guided by the neurosurgeon and his team working together outside the MRI room where you are being closely monitored by the entire team of treatment planning. Your nurse will be with you throughout the procedure, monitoring your blood pressure, heart rate, and well-being and providing you with warm blankets since the room can get quite cold. The MRI imaging enables the neurosurgeon to locate and fine-tune the area that needs to be treated. Small doses of ultrasound energy will be given.

Procedure Completion

  • A follow-up visit is arranged with the neurosurgeon for about two weeks aft er the procedure. • An MRI would be ordered
    for four months aft er the procedure. This MRI can be done at a center close to your home if you are not residing in Richmond, Virginia.
  • You may request a video consult or an o ffi ce visit aft er the MRI to discuss the results.
  • Occasionally some patients may have trouble with balance, dizziness, numbness, or tingling. These effects usually are transient and improve with time. Always stay in touch with your neurosurgeon’s office.