New Jersey Brain and Spine’s Dr. Azmi discusses Essential Tremor, shedding light on this condition, and treatments.
Essential Tremor is a condition that is often genetic.
It’s familial.
It runs in families and it causes tremors often in the hands.
People can have varying degrees of the tremor.
Some very severe, some not so severe but in its more active forms, it could be quite disabling.
It could affect someone’s ability to you know, use their hands.
For example, drinking a cup of coffee, tying their shoe, writing becomes enormously challenging for these patients.
And slowly over time they start to lose their independence even though it is not a life-threatening condition.
It really does affect quality of life in in significant ways both for work and for social.
So, often because there is no effective treatment options, patients just give up on treatment.
They they go to see few neurologist.
They maybe tried on different medications and they may have side effects or the medications may not be effective and they give up, they just live that way for for years.
Up until very recently the only other treatment we had besides the medication that’s available for these patients was surgery called deep brain stimulation where we implant a pacemaker in the brain.
Actually, it’s quite effective in treatment of of the tremors but it is surgery and it carries risks of surgery which we try to of course keep at a minimum but still the risks are there.
And it requires a lifetime of followup and maintenance and adjustments and the pacemaker battery needs to be changed over someone’s lifetime so it is a commitment.
But more recently we’ve have a few additional options that really have changed the landscape of how we treat patients with Essential Tremor.
The most effective and the most impressive one is something called Focused Ultrasound where we use sound waves that are able to pass through the skull without any incisions, without any surgery, and they coalesce on a spot in the brain that we know is involved in generation of the tremors and they cause a small ablation in in that area and they arrest the tremors.
And often this is a permanent treatment.
Now there could be recurrence of about 10% but often patients have tremor relief for years after the procedure.
Another addition to the treatment of tremors are newer wearable devices.
Although not perfect they do offer some relief for some patients and they’re not invasive and the risk is minimal essentially so patients have variety of options to choose from.
Of course we try the least invasive way and often medication is all we need, even if the tremors are severe.