Focused Ultrasound Procedure Provides Life-Changing Relief for Essential Tremor Patients
At Orlando Health Neuroscience Institute, functional neurosurgeons skilled in MRI-guided focused ultrasound offer life-changing relief to patients suffering essential tremor refractory to medication.
FDA approved for treatment of essential tremor and tremor dominant Parkinson's disease, focused ultrasound (FUS) is an incisionless outpatient procedure of targeted tissue thermal ablation performed in the MRI suite. When medications fail to relieve the uncontrollable and debilitating shaking caused by essential tremor — familial or idiopathic — the novel treatment helps control tremors without surgical incisions or permanent implants.
“Debilitating refractory tremors affect a patient’s ability to perform most daily activities — eating, drinking, writing — and patients may suffer for decades,” says Jan Hachmann, MD, with Orlando Health Neuroscience Institute. A dual fellowship-trained neurosurgeon, he specializes in stereotactic and functional neurosurgery, epilepsy surgery and neurosurgical oncology.
During FUS treatment, highly focused ultrasound waves under constant MRI-guidance and clinical testing precisely target the ventralis intermedius nucleus (Vim) of the thalamus. “We do not treat based solely on traditional universal standard coordinates, but use patient-specific direct targeting,” says Dr. Hachmann, who performed Orlando Health’s first FUS procedure in October 2025. “We use advanced imaging capabilities and techniques to directly visualize the dentato-rubro-thalamic tract (DRT), to customize the optimal target location to each individual patient.”
During the procedure, an initial low-dose test determines tremor response and any adjustments that are necessary before making the permanent thalamotomy. The resulting ablation creates a small therapeutic lesion that significantly improves the shaking of essential tremor and Parkinson’s disease.
The result is an immediate and lasting improvement in the treated hand, with average tremor reduction of 70-80% in clinical trials. Recently, the FDA approved treatment of the second hand nine months after an initial successful FUS.
“It’s remarkable,” says Dr. Hachmann, who trained on FUS during his functional neurosurgery fellowship at Virginia Commonwealth University in Richmond. “When patients who have been completely incapacitated for years first see their hand steady, there are many happy tears. FUS is a great addition to the management of movement disorders.”
Orlando Health Neuroscience Institute offers a comprehensive, multidisciplinary movement disorder program that includes leading-edge therapies like deep brain stimulation, FUS, and stereotactic radiosurgery. The institute is dedicated to revolutionizing care with outcomes advanced by skilled specialists dedicated to identifying and customizing treatments to facilitate the best solution for each patient.
