When Medication No Longer Works

Medication is often the first treatment option used for essential tremor. Medication can be an effective method to control tremors, but some patients can find side effects intolerable or that the effectiveness reduces over time. Mary Beth Bidwell, an essential tremor patient who initially started out on medication, learned that medication may not always be the best option—especially now that a new, non-invasive procedure is available.

Bidwell, a 52-year-old bookkeeper for PGA Magazine, experienced essential tremor most severely in her left hand. As many patients with essential tremor have learned, the tremor makes working difficult. The key tasks of her job, including typing and writing, became increasingly complicated due to her hands shaking.

For treatment, she first utilized medication. Propranolol, a common prescription for essential tremor, didn’t stop her tremors. Higher doses of the medication didn’t help, either. Unfortunately, Bidwell did experience side effects: fatigue, weight gain, and low blood pressure.

Bidwell was hesitant to undergo invasive surgery such as deep brain stimulation (DBS). DBS involves inserting wires into a patient’s brain and then stimulating the thalamus with electricity. This surgery can be an effective method to control tremor. However, to Bidwell, a new, noninvasive treatment option called Neuravive seems like a better alternative. This procedure uses MRI to target the affected area of the brain, and then applies focused ultrasound to the area to diminish the tremor.

She signed up for a clinical trial for Neuravive at Penn Medicine. During her treatment, between bursts of focused ultrasound, staff would ask her to draw a spiral to determine the effectiveness of the procedure. At first, she struggled to draw a smooth spiral By the fourth attempt, Bidwell could draw a spiral without any signs of tremor. While Bidwell experienced slight unsteadiness as she recovered, her condition rapidly improved over the following week. She enjoyed her new ability to drink without spilling—and to type accurately at work.

Bidwell is not the only one to experience the benefits of Neuravive. If you’ve found essential tremor medication to be ineffective, Neuravive or another form of treatment may be an option. You can learn more about treatment options that may be available to you by calling the Essential Tremor Education Center at 844-NO-TREMOR.

Educator Spotlight: Holli Hatfield

The Essential Tremor Education Center has assembled a team of educators to answer any questions or concerns you may have about essential tremor treatment, symptoms, and causes. Want to learn more about the team that’s working hard to help you handle your essential tremor? Today we’d like to introduce our educator Holli H.

Holli is passionate about helping others, which naturally led her to join our team of educators. She says, “I have empathy for those in need of help and believe it is one of God’s missions for my life to help others.” She loves making a positive difference in the lives of others by helping them improve the quality of their lives.

Still, education isn’t always easy, and there are challenges to helping others—especially when it comes to spreading the news of new, non-invasive treatments such as Neuravive. Holli has found that patients, due to it being a new procedure, may be reluctant to undergo treatment that directly treats the brain without the use of surgery. Holli says she encourages people with essential tremor to consider Neuravive, because they may experience outstanding, life-changing benefits by controlling their tremor.

Patients who discuss essential tremor with Holli often ask how effective Neuravive is, where they can get the procedure, how long it lasts, and the cost. Holli takes time to answer each question so patients can get the information they need to make a decision about their health. To every patient with questions, she has this to say: “We are here for support, and they can count on us not only as a resource for education and treatment options, but also to support them on a personal level.”

We are grateful for the heartfelt, supportive job Holli has done in educating others about essential tremor treatment. If you’d like to speak to an educator today, you can call the Essential Tremor Education Center at 844-NO-TREMOR. Our educators are happy to answer your questions and provide the information you need about available treatment options.

Timeline of Ultrasound Focused Techniques

We use our hands for almost everything—and essential tremor is most significant when your hands are active. Previous essential tremor treatment options ranged from medication to invasive surgery, which has helped many patients. Technology, however, improves quickly. One year ago, focused ultrasound treatments received FDA-approval for essential tremor, and many patients have benefited from the procedure. Let’s look at how far this procedure has come in only a year.

In July 2016, the FDA approved focused ultrasound as a non-invasive treatment of essential tremor. This approval was based on a clinical trial led by Dr. Jeffrey Elias at the University of Virginia Medical Center. This multi-site study also included a significant contribution from each alliance member: Dr. Travis Tierney at Sperling Medical Group, Dr. Ryder Gwinn at Swedish Neuroscience Institute, Dr. Howard Eisenberg at the University of Maryland, and Dr. Michael Kaplitt at Weill Cornell Brain & Spine Center.  This study included 76 essential tremor patients who enjoyed an average of 70 reductions in their tremor. Physicians in other countries have also been quick to utilize the procedure. It’s currently available in the U.S., Canada, Europe, Russia, Japan, Korea, and Israel. Centers that practice focused ultrasound are experiencing a backlog of essential tremor patients who are seeking a diminished tremor.

Focused ultrasound has since been more widely adopted. November 2016 marked the first step toward commercial adoption when the Division of Outpatient Care within the Centers for Medicare and Medicaid Services specified a reimbursement fee for the procedure. More recently, the most commonly used MRI technology has been approved for use in the treatment—making it more viable for hospitals to perform the procedure with tools they already have available.

While focused ultrasound has helped many enjoy a diminished tremor, the cost is still a concern keeping patients from this treatment. The next step forward will be for insurance companies to establish coverage for payment. This will open new treatment avenues for other patients who have been unresponsive to medication, or hesitant to try invasive surgery.

Focused ultrasound has come a long way since Dr. Elias’ pivotal study, and we’re excited to see how the treatment evolves in the future. Do you want to learn more about focused ultrasound, or other essential tremor treatment options that may be available? You can contact our team of educators at the Essential Tremor Education Center by calling 844-NO-TREMOR today.

 

The Firsts Achieved by Our Essential Tremor Alliance Members

The Essential Tremor Education Center aims to deliver accurate essential tremor information and news to those with essential tremor and their loved ones. To make sure you have the best information possible, we’ve assembled an alliance of medical providers who have been pioneers in researching essential tremor treatment. Today, we would like to highlight the milestones our alliance members have reached in researching and providing a new treatment option to patients, MR-Guided Focused Ultrasound (MRgFUS). This treatment uses MRI to target the area of the brain responsible for the tremor, and then uses focused ultrasound beams to lesion the area, effectively diminishing the tremor for many.

Sperling Medical Group

Located in Delray Beach, Florida, the Sperling Medical Group has been nationally recognized as a leader in MRI-guided technology. Dr. Travis Tierney and Dr. Dan Sperling have also received recognition for their roles in using MRI to treat a variety of conditions. After MRgFUS became FDA-approved, Sperling took this opportunity to use it to treat essential tremor patients, making them among the first in Florida to use MRgFUS to treat the condition.

Weill Cornell Brain & Spine Center

Weill Cornell Brain & Spine Center is a highly recognized hospital in New York, ranking as the #1 hospital in the state for 16 years in a row. Dr. Michael Kaplitt initially participated in the essential tremor clinical trial for MRgFUS and continued performing the procedure for Weill Cornell’s patients just weeks after it was FDA-approved. His work marks the first time that Focused Ultrasound treatment was performed in New York.

All Alliance Members

Each of our alliance members has taken steps toward uncovering new research about treating essential tremor, including:

  • Swedish Medical Center and Dr. Ryder Gwinn, whose research was critical for FDA-approval of Focused Ultrasound treatment for essential tremor.
  • The University of Maryland Medical Center and Dr. Howard Eisenberg, who is an established leader in researching essential tremor.
  • The University of Virginia Medical Center and Dr. Jeffrey Elias, who led an international clinical trial of 76 patients that proved that Focused Ultrasound treatment was a safe and effective option for essential tremor patients.

It’s thanks to our alliance members that we’re able to keep you up-to-date with advances made in essential tremor treatment. They have all dedicated their time to learning more about essential tremor and offering new, quality treatments to those searching for tremor relief. If you’d like to learn more about our alliance members and their accomplishments, you can do so here.