Essential tremor (ET), also called familial tremor, is a frequent movement disorder characterized by tremor during action (posture and movement). An anomaly in the output from cerebellum to thalamus causes an overactivity of the motor thalamus and cortex leading to tremor.
Our approach centers on an interruption of this abnormally functioning pathway without touching the thalamus. This allows the coupling of efficiency and sparing of brain functions, and thus if necessary a tremor relief on both sides.
Where to go to provide an efficient and sparing effect against essential tremor relates to years of work, in our case more than 20 years, of study of the tremor mechanism and its most adequate control thanks to consequent selection of brain targets. The good news is: we can provide tremor relief without reducing motor, sensory and cognitive functions. We can apply this treatment on both sides of the brain if necessary. The long term efficiency of the treatment stands at 80 – 90% mean tremor relief. There is a low risk profile, mainly comprising a bleeding risk in the target, which can be estimated at less than 1%. The risk of collateral damage to structures around the target is significantly reduced by the real-time monitoring of the thermal work, the absence of mechanical brain shift and a targeting accuracy of half a millimeter. Long term negative effects of the ultrasound lesioning process can be excluded thanks to the fact that it is a thermocoagulation, the long term innocuity of which has been demonstrated by more than 60 years of functional neurosurgical activity using radiofrequency thermocoagulation. Long term results of the focused ultrasound treatments are not yet available. However, as the targets we use are exactly the same as the ones we have developed and used over more than 20 years using the electrode penetration technique with radiofrequency , the same long term results can be expected for all our ultrasound treatments, a fact already confirmed by our one-year results with focused ultrasound.
Essential Tremor pathophysiology and treatment explained
Our patients are asked to draw spirals and lines during their pre- and post-operative assessments. The pre-operative assessment artwork of four relevant patients are displayed below. Click on each image to see the post-operative assessment.