FocusNeuro Tremor Treatment
FocusNeuro treatment process:
Request an Initial Consultation
If you are suffering from Essential Tremor, Parkinson’s disease or another type of tremor or movement disorder and would like to know whether you might be suitable for treatment with focused ultrasound, please fill in the following information and our clinical care coordinator will contact you:
Date of Birth:
Mobile phone number:
Alternatively, please email your referral or enquiry to firstname.lastname@example.org
Our assessment process includes:
- Confirmation of your diagnosis and its impact on your quality of life.
- Other relevant medical condition and medications you are on.
- Brain scanning with MRI and CT
Our clinical assessment team includes a movement disorder neurologist and neurosurgeon. Our clinical care coordinator will coordinate all aspects of your assessment from the time we receive your referral.
Phone: +61 3 8862 0000
We provide a multidisciplinary approach to patient care, in order to provide the best possible treatment. Our multidisciplinary team includes:
- Rehabilitation physicians
- Pain specialists
Not only do we strive to offer technical expertise of the highest standard, we also provide pre- and post-treatment care, including rehabilitation, in order to optimise your outcome and facilitate the timely and successful transition to your improved physical functional state.
What is the Treatment Process?
- PATIENT PREPARATION
Several days or weeks before treatment, a CT scan is done to assess the shape, thickness and density of the patient’s skull. If the skull is too thick or dense the patient may be unsuitable for this treatment. A urinary catheter may be placed to drain the bladder. Vital signs (heart rate, blood pressure, oxygen level) will be monitored.
The patient is positioned on the treatment bed in the MRI room with their head places in the Exablate Neuro helmet. Cool water is circulated around the scalp to avoid heating.
2. PLANNING, TESTING AND TARGET VERIFICATION
MRI images are taken to plan the treatment and identify the target.
Prior to treatment, low energy ultrasound energy is applied to accurately pinpoint the target on the real-time MRI. Then, several moderate level ultrasound pulses allow assessment of therapeutic response and any potential side effects.
The actual focused ultrasound treatment comprises up to 1024 ultrasound waves precisely converging at the target in the thalamus. At that focal point, temperatures increase to around 60°C, causing thermal ablation of the tissue. Active monitoring is undertaken during the procedure to ensure accuracy and safety. This is achieved with MRI-guided feedback of temperature changes at the target. Treatment is generally unilateral, typically treating the dominant and/or most severely affected hand.
The patient is clinically assessed during and immediately after the procedure. The outcome is confirmed using an MRI scan immediately post-procedure. Treatment typically takes between 3-4 hours. Many patients experience an immediate reduction in their tremor and frequently return to normal daily activities the following day.
What are the outcomes?
Most patients experience a significant improvement to their tremor through the treatment process.
Published outcomes include the following improvements in tremor when compared to baseline (pre-treatment):
1 yr after treatment- 69%
2 yrs- 75%
3 yrs- 76.5%
In tremor-dominant Parkinson’s disease, the study that led to FDA approval reported a 62 percent median improvement in hand tremor 3 months after treatment compared with baseline.
What About Side Effects?
Like any type of surgical procedure, potential side effects and complications occur from time to time.
Side-effects reported include numbness in the face or hand, and gait disturbance. In most cases these are mild and temporary, but they can be ongoing in some patients.
The long-term safety profile indicates that 74% of adverse events were mild, and the rest were moderate. Of the total adverse events, almost 50% resolved within 30 days of the procedure.
Specifically, the most common side effects are:
- musculoskeletal weakness 2%
- gait disturbance 2%
- unsteadiness or imbalance 4%
- numbness 9%
How long does the tremor reduction last?
Current studies on Essential Tremor provide up to 3-4 years of outcome data, with the vast majority of patients obtaining a good and sustained benefit.
What is the process to be assessed?
Step 1 – Register your interest
You can contact our office by phone (03 8862 0000), email (email@example.com) or via our website to register your interest and begin the assessment process.
Step 2 – Phone Consultation
A member of our team will call you to obtain some relevant information, screen you for suitability, and arrange the medical and radiological assessments (if appropriate).
Step 3 – Medical Assessment
The key medical assessments are:
- Consultation with a movement disorder neurologist
- CT & MRI Scan
- Consultation with neurosurgeon, Prof Richard Bittar
The information obtained during your consultations and scans are collated and assessed by our multidisciplinary team, and a treatment recommendation is made.
Step 4 – Scheduling the Procedure