Neuravive is a new treatment for essential tremor where sound waves are focused through the skull to a target without the need for incisions, brain implants or radiation. It is based on high intensity focused ultrasound guided by MR imaging.
During the procedure, ultrasound waves pass through the skull and are focused on a specific target in the brain. The temperature at the target rises high enough to create a small ablation, or burn and provide a therapeutic effect, reducing the hand tremor.
The MRI scanner provides images for the physician to clearly see the treatment area and to show changes in temperature at the target.
On treatment day, your head will be shaved so that nothing will interfere with the ultrasound beams. Your hair will naturally grow back after the treatment. After local numbing medication is applied, a frame will be secured to your head and an elastic cap is placed to seal the helmet, where water is circulated.
As the treatment last about 3 hours, a urinary catheter is placed so you won’t need to go to the bathroom. Your heart rate, blood pressure and blood oxygen levels will be monitored throughout the procedure.
During the treatment, you will lay down on the treatment bed inside the MRI scanner. The medical team will be in the control room and you will be conscious and able to communicate with them. Your head will be positioned in the focused ultrasound helmet which is filled with water, and you will have a blanket to keep you warm.
You will be given a “stop sonication” button if for any reason you want to stop the procedure. MR images are taken to plan the treatment.
Your physician will first apply light doses of ultrasound energy to identify the right spot in your brain for treatment. Then full intensity ultrasound energy will be applied. The temperature at the target rises high enough to create a small ablation, or burn and provide a therapeutic effect, reducing the hand tremor. The treatment bed will move in and out of the MRI.
After each application of ultrasound energy, you will be asked to do tasks such as drawing spirals. This is so the physician can evaluate the improvement of your tremor and any potential side effects.
Although individual results may vary, you should notice improvement during the treatment itself. At the end of the procedure a final MRI scan will be done to assess the treatment. The frame will be removed and you will go to a recovery room.
Your physician will let you know when you can go home and when you will need to return for any follow-up visit.
Within days you can return to normal activities.
First, there is the possibility that your tremor may return months or even years after the Neuravive treatment, or that the tremor may not improve at all. There is a small risk that you could develop temporary or permanent muscle weakness, unsteadiness, sensory loss, or numbness or tingling in your fingers or elsewhere in your body.
And while the treatment may improve your tremor, it’s important to understand that it does not treat the underlying disease nor prevent its progression.
For short periods of time during the treatment you may experience nausea, pain or other sensations. For several months following the treatment, you may experience tingling or numbness in your fingertips or elsewhere in your body and in some cases unsteadiness when walking.
*FDA Labeling: The Exablate Neuro is intended for use in the unilateral thalamotomy of idiopathic essential tremor patients with medication-refractory tremor. patients must be at least age 22.
**Disclaimer: The information provided here should not be considered medical advice and is not intended to replace consultation with a qualified physician. Please consult with your physician or clinic for diagnosis and treatment.