Johns Hopkins Uses Focused Ultrasound to Treat Essential Tremor

Neurologists at Johns Hopkins Medicine used MRI-guided high-intensity focused ultrasound to treat an 80-year-old ^[1] man with essential tremor.

This procedure offers a critical alternative for patients who cannot undergo traditional brain surgery due to comorbidities or those who do not respond to medication. By targeting the brain without an incision, doctors can reduce the risks of infection and hemorrhage associated with invasive thalamotomies.

The patient presented with essential tremor that had become refractory to multiple medications. Because the patient also had diabetes, conventional surgical options were considered too risky. The medical team opted for a focused-ultrasound approach to target the ventral intermediate nucleus (Vim) of the thalamus.

During the procedure, neurologist Kelly Mills and the surgical team used real-time MRI guidance to deliver concentrated ultrasound energy to the specific target in the brain. This process creates a small, precise lesion that disrupts the abnormal electrical signaling causing the tremors. Unlike traditional surgery, this method does not require the opening of the skull.

The non-invasive nature of the treatment allowed the patient to remain awake, enabling the medical team to monitor the reduction of tremors in real time. Following the procedure, the patient showed marked improvement in symptom control.

Focused ultrasound is increasingly used for movement disorders when pharmacological treatments fail. The ability to treat elderly patients with complex medical histories, such as diabetes, expands the pool of candidates eligible for symptom relief.