Home Forums Other Specialities Neurology & Neurosurgery A New Treatment for Essential Tremor

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    A new treatment for essential tremor being pioneered in the UK by clinicians at Imperial College Healthcare NHS Trust has been recommended by NICE. NHS England will now need to consider whether to fund the new procedure for suitable NHS patients in England. Essential tremor is a brain disorder characterised by uncontrollable shaking that affects over one million people, with around 250,000 severely disabled by the condition.

    Current treatments – including drug therapies, surgery and deep brain stimulation – are of limited effectiveness or cannot be used in all sufferers, and some have significant risks and side effects. The new treatment, MRI-guided focused ultrasound, is being used for essential tremor in a number of centres around the world and the first UK clinical trial took place at St Mary’s Hospital last year. Treatment involves using real-time MRI imaging to focus ultrasound on a specific area of brain tissue. At that point, molecules are vibrated extremely quickly which creates intense local heat to destroy only the targeted tissue and break the abnormal electrical circuits causing the tremor.

    In the St Mary’s trial – led by consultant radiologist Professor Wladyslaw Gedroyc, consultant neurologist Dr Peter Bain and consultant neurosurgeon Mr Dipankar Nandi – the procedure was used to treat 13 patients. Results have been very promising so far, with an average 70 per cent reduction in tremor symptoms. The full results of the trial are expected to be published later this year.

    The updated guidance, published by NICE on 20 June, recommends MRI-guided focused ultrasound to treat essential tremor provided there are special arrangements for clinical governance and patient consent, and that outcomes are audited and recorded to help with assessment of its long term effectiveness.

    The Imperial College Healthcare team are also exploring how the procedure could be used to treat other brain disorders, starting with Parkinson’s disease. In the future, it may also be used to treat tumours, epilepsy and perhaps dementia.

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