Treatment Stages

The treatment takes place while you are lying in an MRI system. But before entering the MRI, your head will be shaved and cleaned.  You will be given a local numbing medication and an immobilizing frame will be secured to your head, to keep you from moving during the treatment.  This will likely be the most uncomfortable part of the procedure.

You will have a urinary catheter placed to drain your bladder during the procedure, so you won’t have to go to the bathroom. Your heart rate, blood pressure and blood oxygen levels will be monitored throughout the procedure. You will then lie on the treatment bed which will move in and out of the MRI system. You may be given additional medication to keep you comfortable. You will be conscious, communicating with the physician and nurses throughout the treatment.

First, you will lie on the treatment table, moving in and out of the MRI as series of MRI images will be taken for the purpose of planning the treatment.  The physician will mark the area to be treated on the software and light doses of ultrasound energy will be administered in order to ensure the proper spot in the brain has been located.

During the procedure, you will be asked to perform specific tasks in order to verify that the treatment location is exactly on target. Certain tasks may include touching your nose with your finger and/or drawing circles on a board. Once your physician is confident of the proper location, the focused ultrasound will be used to make the permanent burn of that location. Concentrated ultrasound waves will be directed at the identified spot for approximately 10 – 40 seconds, heating the area somewhat but not to the point of creating the destructive lesion yet. This is called a sonication. Doctors will monitor the effect on your tremor in real-time and continue with additional sonications as needed to be certain that you will have the best outcome. During the procedure, cool water will be circulating in the helmet that surrounds your head and your body will be kept warm.  You will also be given a “stop sonication” button in order to indicate to the physician that you want to stop the procedure for any reason.  When the doctors are sure of the treatment location, they will apply the final heating to ablate the target.   The entire treatment will most likely last between 3-4 hours from when you get on the treatment table and until you get off.

After treatment, you will move to the recovery room for observation. The frame and the transducer helmet will be removed from your head. You will be able to leave the MRI machine and walk out of the treatment.   You will rest in the hospital for up to 24 hours and at some point you will have a final 20 minute MRI scan without a frame for post treatment assessment. Your physician will let you know when you will need to return for any follow-up visit.