MRI-guided Focused Ultrasound (MRgFUS) The advancement in radiology that faculty of medicine Siriraj hospital

The advancement in radiology that faculty of medicine Siriraj hospital has recently utilized is therapeutic technology employing MRI-guided Focused Ultrasound (MRgFUS) to treat the essential tremor (ET) effectively. Siriraj has applied this novel technique for the first time in Thailand since 2020 and could help the patients to avoid the open surgery, thereby avoiding surgical risks and shortening their hospital stay.

What is the Essential Tremor (ET)?

ET is a rare yet devastating movement disorder that usually triggers bilateral tremors during intentional movements, for example, writing, eating, drinking, etc. that significantly limit daily life activities, especially in the elderly.

The Diagnosis of Essential Tremor

The diagnosis of ET primarily relies on the medical history and physical examination as imaging modality like CT or MRI almost always yields normal results. Surgical treatment is indicated in severe cases when lifestyle adjustments and medications fail to maintain the patient’s ability to accomplish their routine tasks. As surgery always carries some preoperative and postoperative complications, MRgFUS is a preferable option to help those patients to retrieve their ability with minimal surgical risks.

The success of MRgFUS in treating Essential Tremor

With the capacity to identify as small as 4-5 mm. lesions precisely, and also the capacity to control the temperature at the lesion in a real time fashion, the success of combining MRI technology and Focused Ultrasound in treating ET is now recognized by many countries including the USA, Switzerland, Italy, Japan, Australia, Korea, and so on.

The studies showed that 60% improvement can be achieved after treatment. The only limitation of the technique is it works on one side of the body at a time. A few complications such as numbness or temporary ataxia have also been reported and usually disappear after 3 months of therapy.

The key of success of this new technique is the multidisciplinary approach of the caregiver team including neurologist, neurosurgeon, radiologist, technician, physiotherapist, and nurses who have been working in concert to help the patients to live their lives as happily as possible.