Patients' Tremors Stopped After New Non-Invasive, Pain-Free Brain Surgery
MRI-guided Focused Ultrasound Surgery may one day be used on cancers, tumors.
Jan. 23, 2012 -- Phyllis Walker's hands used to shake so badly she had to stop eating at the dinner table with her family.
"As a normal thing, I pretty much ate over the sink, so that I wouldn't spill things," the 77-year-old grandmother from Ivor, Va., said. "I could not use a fork and knife, couldn't -- just didn't want to sit at the table and be embarrassed."
Just four hours away in Burtonsville, Md., 56-year-old Dot Highberg was also losing control of her hands. She tried medication after medication, each working for awhile, but eventually, the shaking would return with a vengeance.
"The tremors were just getting worse and worse. It wasn't getting better and it wasn't going to get better," Highberg said. "It looked like I was gonna be on medication for the rest of my life."
Diagnosed with essential tremors, a neurological disorder that causes patients to lose control of their hands, heads and voices, both women were desperate for help. They were each forced to stop doing the things they loved.
Walker, who has two grandsons serving in Iraq and Afghanistan, was no longer able to write letters to give them a grandmother's advice, or receive communion at church. The shaking was so bad that it started affecting her everyday life.
"I couldn't cook, because I couldn't measure ingredients without spilling them. I couldn't take things out of the oven. I was afraid I would spill those or burn myself," she said. "I couldn't brush my teeth like I wanted to, because I would injure my mouth."
For the women and an estimated 10 million other Americans who suffer from the disorder, life was a struggle.
"It was… a matter of not being able to have control. It's like the tremor had control of you -- you didn't have control of it," said Highberg.
Until one day they both got the chance to take back control of their lives. Dr. Jeff Elias, associate professor of neurology at the University of Virginia, and his team were beginning a clinical trial for patients suffering from essential tremors -- using a technique stripped right from a scene in a science fiction movie. Elias was planning to use ultrasound waves, focused to a specific point located by using an MRI machine, to treat the part of the brain that was causing the shaking.
"We're able to focus these 1,024 ultrasound beams to a single point and -- treat or -- or disrupt a lot of the tremor cells that are causing the problem," he said. "Essentially tremor's a neuro-degenerative problem, like Parkinson's disease. And it probably develops from an abnormal circuitry in the brain. And we're able to treat that circuit and restore it to a more normal condition."
Walker, who learned about the surgery from her daughter-in-law, immediately took interest.
"It sounded like a miracle," she said. "I was considering the deep brain surgery...I really didn't want to do that."
She was accepted into the trial and underwent the procedure in August 2011 for the shaking in her right hand. The results were immediately clear -- once the four-hour procedure had ended, Walker's shaking had stopped. The doctors and nurses were able to test the patients while they were wide awake to make sure they were hitting the correct spot with the ultrasound waves.
"The girl was in there testing whether I could draw circles or write my name and so forth. And it was immediate. I could write my name," said Walker, who's handwriting was illegible just hours before. "I was surprised -- very pleased."
"This M.R.I.-guided focused ultrasound allows us to actually visualize the entire treatment, while it's being delivered," said Elias. "And we still have the ability to interact with a patient and refine and polish the procedure."
The procedure was unique not only in that it could safely and immediately deliver results, but also because it's reportedly pain-free and there is virtually no recovery time. Patients were required to stay overnight in the hospital for observation, but both were able to walk, talk and perform tasks that they weren't able to in years after they left the MRI machine.
For Highberg, who underwent the procedure in October, the surgery was a miracle.
"I was able to eat fruit without it falling off of the spoon, without it falling off the fork, I was able to drink without using both hands and without shaking," she said, amazed that she could complete such a simple task. " It was wonderful."
Walker's quality of life has done a complete 180 degree turn.
"I feel much better. I feel like I can do most anything I want to do, for 77 years old," she said. "I would do it again in a minute."
For Elias, a successful trial using focused ultrasound surgery is just the tip of the iceberg.
"We could send ultrasound waves to almost any organ of the body. So cancers, strokes, Parkinson's disease, epilepsy. They're really all potentially treatable with this type of technology," he said.
For the people undergoing the procedure, like Walker and Highberg, their lives are completely changed in that they can finally live normal lives. Highberg is now back to performing her passions -- quilting and cooking -- and is even thinking about picking up an old hobby -- playing the piano.
"After the surgery...I can do it, I can do it! I just wanna say I'm just, out there, I just can do it, You name it, I can do it," she said. "I felt like, alright I am back to normal, I can be a normal person again. Yeah, it was really cool."