HIFU: An Outpatient Procedure that Treats Essential Tremor

Jack Shostak has had essential tremor since he was a child. A condition that ran in his family, essential tremor is a neurologic condition that causes involuntary shaking.

For Shostak, simple activities like eating became a challenge. Duke Health neurosurgeon Stephen Harward, MD,PhD treated Shostak's right hand using high-intensity focused ultrasound (HIFU).

HIFU is an option for some patients for whom medication is not doing enough to control their involuntary shaking. This FDA-approved treatment requires no incisions and can reduce severe tremors by about 70%. 

HIFU relies on an MRI technique called diffusion tensor imaging to accurately target and direct sound waves to a tiny area of the brain that helps regulate movement. The focused ultrasound energy creates enough heat to selectively interrupt signals that cause tremors.  

“When we disconnect that tremor circuit, the tremor stops,” said Duke neurosurgeon Nandan Lad, MD, PhD.

This short, outpatient procedure requires no incisions and offers immediate results.

Today, Shostak’s right-hand tremor is barely noticeable. He will receive HIFU treatment for his left hand at a later date.

Watch Shostak's story in this 6-minute documentary:

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