Focused ultrasound treatment relieves debilitating essential tremor for Virginia patient

Left-handed Lydia Willett of Victoria, Virginia, was used to performing daily tasks with her non-dominant hand. “I’ve gotten really good at eating with my right hand. Of course, you can’t brush your teeth or write a letter with your non-dominant hand,” Lydia says.

For almost 30 years, Lydia had suffered from essential tremor, a movement disorder unrelated to Parkinson’s disease that can be very incapacitating, interfering with tasks like cooking, writing and working on a computer. According to the International Essential Tremor Foundation, an estimated 10 million Americans have ET.

However, a visit with her sister, who also suffered from essential tremor, prompted Lydia to seek help. “While visiting my sister, she started sobbing and went to put her hand up to her eyes to wipe her tears. She couldn’t because her hand was flopping around like a fish. I vowed to never let myself get that bad.”

After meeting with multiple doctors and trying various medications, Lydia found her way to Dr. K. Singh Sahni, chairman of neuroscience and medical director of the Gamma Knife Center at HCA Healthcare’s Johnston-Willis Hospital in Richmond, Virginia.

“I know this is going to sound strange, but when I first saw Dr. Sahni, I just knew he was the one,” Lydia says. “He is my hero and the best of the best. We saw eye to eye from the start.”

Dr. Sahni says the most common treatment for essential tremor is medication, which a lot of patients benefit from if the tremor isn’t very severe. For more severe cases, however, there are three surgical options: deep brain stimulation (DBS), Gamma Knife and now focused ultrasound.

With DBS, an electrode is implanted in the thalamus, the region of the brain that controls the tremors, and connected to a pacemaker-like device in the chest. Gamma Knife involves radiation and patients typically don’t see results for three to six months. The latest treatment, focused ultrasound, is the least invasive, involves no radiation and results are almost immediate. Dr. Sahni says there are few limitations to who would qualify as a good candidate for focused ultrasound treatment, but one includes skull density. A CT scan would need to be performed to know if focused ultrasound will work.

For Lydia, Dr. Sahni, along with neurologist Dr. Matthew Boyce, used this new, incisionless treatment that targets the thalamus with sound energy instead of radiation. Johnston-Willis Hospital is the only hospital in central Virginia offering this treatment for medication-refractory essential tremor and tremor-dominant Parkinson’s disease patients. It is also one of only a few hospitals that offers all three surgical options for essential tremor, giving patients a choice based on their medical condition and preferences.

“Focused ultrasound guided by magnetic resonance imaging provides patients suffering from debilitating tremor with an incisionless treatment option, which can often be performed on an outpatient basis with short recovery time,” Dr. Sahni says. “This non-invasive technology gives our patients more treatment options as they decide with their physicians the best course to get back to a more independent and active lifestyle.”

Lydia saw an immediate transformation after the focused ultrasound treatment. At work, she frequently uses her hands to give change, stamp checks and look up information on the computer. “It’s a huge relief for me to be able to work now without my tremor,” Lydia says. “The computer mouse does not scoot around like a real-life mouse anymore!”

Lydia adds that she can brush her teeth, use scissors and turn book pages without them rattling, but she’s most excited to be able to write — especially to her son.

“As my mother used to write me letters, I want to keep that tradition alive for my family,” Lydia says. “This time, as I wrote my letter, it was amazing. I didn’t have to scratch anything out and write him a legible letter.”

For Dr. Sahni, he says this procedure is “absolutely miraculous” and he and his team consider themselves very fortunate to be able to offer it.

“I’ve been in neurosurgery for over 30 years and I do many different procedures,” Dr. Sahni says. “We’ve had some very good results, but overall, these are challenging [cases]. But this is so rewarding because you see a patient who comes to you and has a miserable lifestyle and walks out happy that day. I’ve seen patients actually cry on the table, men and women. You give the patient a bottle of water while on the table … and when they put the bottle to their mouth and they’re not hitting their face, they’re so excited. Some of them haven’t done that for years. So that’s very rewarding.”

Learn more about focused ultrasound treatment: johnstonwillismed.com/focusedultrasound