Essential Tremor and Parkinson's Disease
Our Approach to MR-Guided Focused Ultrasound
Magnetic resonance (MR)-guided focused ultrasound (MRgFUS) is a noninvasive treatment that combines magnetic resonance imaging (MRI) and sound waves (ultrasound) to target a specific area of your body. We use MRgFUS to treat many conditions, including essential tremor, Parkinson’s disease, prostate cancer, cancer that has spread to your bone (bone metastasis), and uterine fibroids.
Stanford Health Care doctors are world-renowned in image-guided procedures such as MRgFUS. Our neurosurgery and radiology teams work together to offer you the most effective and least invasive therapies to help improve your condition.
Our doctors have performed MR-guided focused ultrasound procedures since 2013. We continue to research the latest uses for this innovative treatment to bring you the highest level of care and optimize your outcome.
900 Blake Wilbur Drive
Palo Alto, CA 94304
Phone: 650-498-6148
What We Offer You With MR-Guided Focused Ultrasound
- Multispecialty team to advise you on the best treatment approach
- Internationally recognized specialists with extensive experience using noninvasive MRgFUS to successfully treat many conditions
- Active research into new uses of MRgFUS, including ongoing trials on Parkinson’s disease, prostate cancer, and bone metastases
- Designation as a Center of Excellence by the Focused Ultrasound Foundation in recognition of Stanford’s leadership in ultrasound research and treatments
What Is MR-Guided Focused Ultrasound?
Essential Tremor and Parkinson's Disease
We use MR imaging to plan and monitor your treatment. We target areas of your brain that cause your tremor or Parkinson's symptoms. The treatment takes about 3 hours, and you can usually return to your regular activities about a day after treatment. MRgFUS usually improves tremor around 50% after treatment, and results last up to 6 years.
We will first do a CT scan of your head to calculate your skull density ratio (SDR), a number that estimates whether ultrasound can penetrate your skull to reach the target in your brain. 90% of patients have skulls suitable for MRgFUS.
Before the procedure, we use local anesthesia to numb your scalp so we can place a frame on your head to keep it still inside an ultrasound helmet. During the procedure, we direct the ultrasound to burn tiny areas in your brain that are causing your tremor or Parkinson's symptoms. We can see in real-time whether the tremor or symptoms are reduced and adjust the ultrasound as needed to target any remaining tremor or symptoms.
You may be a good candidate for MRgFUS to treat tremor related to essential tremor or Parkinson’s disease if you have:
- A skull suitable for ultrasound treatment, as measured by SDR
- Symptoms resistant to other medical treatment, such as if medications didn’t work, stopped working, or led to intolerable side effects, or if you don’t want to take medications
Common risks may include:
- Dizziness
- Headache during or after treatment
- Pain or discomfort during treatment
More unusual or rare risks may include:
- Disorientation
- Lightheadedness
- Nausea or vomiting during treatment
- Temporary numbness, tingling, eye twitch, heightened sensitivity of your senses (hyperesthesia), and/or tingling or numbness (paresthesia) of your scalp or face, related to local anesthesia used to place the head frame
Side effects related to burning (ablation) or swelling outside of the targeted area may include:
- Change in taste
- Change in your ability to walk (gait disturbance)
- Numbness or tingling in your face or fingertips
- Slurred speech
- Weakness of your hand or leg
About 30 to 50% of patients will develop swelling-related side effects in the weeks after the procedure, but side effects will improve in about 90% of patients within 1 to 3 months.
What to Expect During MR-Guided Focused Ultrasound
We use MRI to guide and control the MRgFUS treatment, which we perform while you lie in an MR scanner. We use detailed images of the body area we’re targeting to pinpoint, direct, and continuously monitor your treatment.
Before
During
After
Before the Procedure
During your initial evaluation, you see a team of specialists who will determine if MRgFUS is the right treatment for you. We also discuss other treatment options that may be available to you.
Once we have explained all the risks associated with the device and the procedure, you may be scheduled for treatment.
The day of treatment
Before your MRgFUS procedure, we:
- Shave the skin over the target area.
- Give you compression stockings to wear during the procedure.
- Insert a tube (urinary catheter) to drain your bladder.
- Insert a plastic tube into a vein through your arm (intravenous catheter). The catheter gives you fluids and medications to dull your pain and make you comfortable.
We then position you on the table so you are comfortable and supported. We will monitor your heart rate, blood pressure, and blood oxygen levels throughout the procedure.
During the Procedure
We move you into the magnetic resonance (MR) device. We perform the MRgFUS procedure from a computer in the room adjoining the MR suite. Your doctor can see you through a window into the MR scanner room. Your doctor and a circulating nurse are close by to check on you and to give you medication.
We take a series of MR images to help plan the treatment. Your doctor marks the area to be treated. Then the MR device prepares the ultrasound beams to cover the targeted area. Your doctor reviews the plan and optimizes it for your treatment.
To start, the MR device delivers very low-strength ultrasound pulses to ensure that the MR and the ultrasound probe (transducer) are aligned properly. After that, your doctor adjusts the strength of the ultrasound beams as the transducer moves over the area marked for treatment.
Once the treatment is finished, we give you a contrast agent through an intravenous catheter. We obtain a final series of MR pictures to see how well the targeted area was treated.
After the Procedure
You move to a recovery room for observation for 1-2 hours. Once your sedation has worn off, we remove all the monitoring equipment and catheters. Your doctor will come by to evaluate you and to explain the post-treatment care you may need. Your doctor will let you know when you can go home, which is almost always the same day, and when you will need to return for a follow-up visit.
When to call your doctor
If you experience severe pain that doesn’t go away with the medication your doctor has prescribed for you, or you have a fever of 101°F or higher within 48 hours of treatment, call your doctor. We will give you a follow-up phone call the next day and schedule you for a post-treatment follow-up visit.
Before the Procedure
During your initial evaluation, you see a team of specialists who will determine if MRgFUS is the right treatment for you. We also discuss other treatment options that may be available to you.
Once we have explained all the risks associated with the device and the procedure, you may be scheduled for treatment.
The day of treatment
Before your MRgFUS procedure, we:
- Shave the skin over the target area.
- Give you compression stockings to wear during the procedure.
- Insert a tube (urinary catheter) to drain your bladder.
- Insert a plastic tube into a vein through your arm (intravenous catheter). The catheter gives you fluids and medications to dull your pain and make you comfortable.
We then position you on the table so you are comfortable and supported. We will monitor your heart rate, blood pressure, and blood oxygen levels throughout the procedure.
close Before
During the Procedure
We move you into the magnetic resonance (MR) device. We perform the MRgFUS procedure from a computer in the room adjoining the MR suite. Your doctor can see you through a window into the MR scanner room. Your doctor and a circulating nurse are close by to check on you and to give you medication.
We take a series of MR images to help plan the treatment. Your doctor marks the area to be treated. Then the MR device prepares the ultrasound beams to cover the targeted area. Your doctor reviews the plan and optimizes it for your treatment.
To start, the MR device delivers very low-strength ultrasound pulses to ensure that the MR and the ultrasound probe (transducer) are aligned properly. After that, your doctor adjusts the strength of the ultrasound beams as the transducer moves over the area marked for treatment.
Once the treatment is finished, we give you a contrast agent through an intravenous catheter. We obtain a final series of MR pictures to see how well the targeted area was treated.
close During
After the Procedure
You move to a recovery room for observation for 1-2 hours. Once your sedation has worn off, we remove all the monitoring equipment and catheters. Your doctor will come by to evaluate you and to explain the post-treatment care you may need. Your doctor will let you know when you can go home, which is almost always the same day, and when you will need to return for a follow-up visit.
When to call your doctor
If you experience severe pain that doesn’t go away with the medication your doctor has prescribed for you, or you have a fever of 101°F or higher within 48 hours of treatment, call your doctor. We will give you a follow-up phone call the next day and schedule you for a post-treatment follow-up visit.
close After
Our Clinics
900 Blake Wilbur Drive
900 Blake Wilbur DrivePalo Alto, CA 94304
Phone: 650-498-6148 Getting Here
To schedule an appointment, please call 650-498-6148.