CHI Health St. Mary's offers procedure that reduces, and even stops, essential tremor

This year CHI St. Mary's has done 53 focused ultrasound procedures, more than any other...
This year CHI St. Mary's has done 53 focused ultrasound procedures, more than any other hospital in the nation. (Source: Mackenzie Huck)(KOLNKGIN)
Published: Oct. 27, 2019 at 4:13 PM CDT
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Nearly 7 million people in the United States suffer from an essential tremor, but a Nebraska hospital now has a way to reduce and even stop tremors with a procedure known as focused ultrasound.

Charles Punter had been suffering from essential tremors in his right hand since 2017.

"About two years ago I started noticing tremor with my head first," Punter said "A little shake. Well, I didn't notice it, my wife did. And then it moved to the hand and got a little worse."

Punter said that it affected every aspect of his life.

"Can't keep food on the fork, couldn't eat with my right hand, same thing with shaving," Punter said. "Holding a bottle of water just became impossible."

Essential tremor also kept him from some of his favorite hobbies.

"I still ride motorcycles, but if you ride motorcycles, you know the right hand is the throttle," Punter said. "So as I'm going down the road trying to steady my hand I'm putting down the road kind of erratically."

A friend of his told him about a non-invasive procedure that could stop the tremor called focused ultrasound.

"He googles it and finds the procedure and when I heard Mayo Clinic was doing it, that kind of cinched, hey, this must be ok," said Punter.

The treatment is only available at around 20 hospitals in the nation. Mayo Clinic had a wait time of a year and a half, but CHI St. Mary's in Nebraska City was only a month wait.

Punter came all the way from Chicago to have this procedure done.

The procedure works by targeting the part of the brain where the tremor cells form with ultrasound, or high-frequency sound waves, to destroy those cells.

"The sound waves are focused through the skull into one point, about a 3 mm by 3 mm spot," said Dr. Travis Tierney, neurosurgeon. "And where all those sound waves cross they tend to heat up the tissue so it's the thermal energy and not the sound that kills the tremor cells."

Punter was awake the entire procedure and Dr. Tierney was able to test the tremor in real time.

"We have to go in and make sure he isn't experiencing any numbness in his hands or mouth because that says to me we aren't in the exact right spot and we need to move another mm or two," Dr. Tierney said.

Focused ultrasound is currently only FDA approved to treat one side of the body. Bilateral treatment is not yet available, however, clinical trials for second side thalamotomy are happening soon. The second side would only be performed months after the first side is completely healed.

Dr. Tierney said Punter's case was really unique, because it was unilateral. He only has shaking in one hand. But, he also experienced tremors when he was moving, and when his hand was still.

"He had a really severe tremor with a rest tremor component," said Dr. Tierney. "So the action tremor, when they reach out for things, that's easy to stop. But the rest tremor is hard and we spent some time on that and I think we had a nice outcome."

Focused ultrasound typically takes between one to three hours. Afterwords Punter and his children were able to see instant results.

Now tremor free, Punter says he's most excited to stop taking tremor medication and return to a normal life.

This year CHI St. Mary's has done 53 focused ultrasound procedures, more than any other hospital in the nation.

Dr. Tierney said the reason is simple.

"What you need is a specific MRI magnet machine to be able to perform that procedure, but then you also need the machine to be available and not tied down doing other procedures, and I think St. Mary's offers that where a big hospital can't always," Dr. Tierney said.

Dr. Tierney said the procedure is successful in stopping tremors, but should mostly be used for essential tremor and not necessarily to combat Parkinson's Disease.

For treating Parkinson's Disease, Dr. Tierney recommends Deep Brain Stimulation, a more invasive surgery.

If you have essential tremor and are considering focused ultrasound, Dr. Tierney said the best candidates are younger and able to walk without assistance, since many people experience vertigo and dizziness in the few weeks after the procedure.

For more information on essential tremor and CHI Health St. Mary's focused ultrasound program,

https://www.chihealth.com/en/services/neuro/neurosurgery/focused-ultrasound.html