You’re Never Too Old to Control Essential Tremor

“One of the main dilemmas that’s pretty common to a lot of people who are getting older is the idea that maybe there’s a finish line and that maybe there’s a time in your life when you start to slow down and stop and smell the roses and just kind of settle into what will be a comfortable period in your life.” – Chris Cornell

Many people who have a movement disorder called Essential tremor (ET) can’t imagine looking forward to a future of settling into comfortable Golden Years. ET is anything but comfortable. It is characterized by uncontrollable rhythmic movements of hands, head, voice or other parts of the body. Roughly half of cases appear to be inherited, though specific genes have not yet been identified. ET can begin at any age, including early childhood; for those whose tremors started early, they’ve had to experience lifelong hurdles. But for most people, the onset of ET most frequently occurs at midlife or beyond. According to the International Essential Tremor Foundation, “Researchers estimate that 4% to 5% of people age(s) 40 to 60 have ET. The incidence rate for people age 60 and older is estimated at 6.3% to 9%.”[i]

Dealing with ET adds new challenges to aging, regardless of when it began, because it is progressive. Not only can tremors worsen, and begin to involve other parts of the body, nonmotor symptoms (mental and emotional problems) can develop. This means that for the millions of people who are aging with ET, the gradual limitations that normally begin around age 65 are further complicated by ET-related disabilities. In short, ET makes it tough to find anything rosy about becoming elderly.

New study brings hope for elders with ET

However, the future for those aging with ET does not have to be bleak. A revolutionary FDA-approved noninvasive neurosurgical procedure can immediately stop tremors in the dominant hand. It is called Neuravive®, and it consists of using MRI guidance to deliver ultrasound energy harmlessly through the skull to a very small focal point in the brain called the VIM nucleus. (The descriptive term for this outpatient procedure is MRI-guided Focused Ultrasound, or MRgFUS.) At the focal point where the ultrasound waves converge, enough heat is generated to deaden this specific point in what is called the tremor pathway. When this occurs, the abnormal tremor messages in the brain are effectively interrupted so they never reach the affected hand. Now, a 2020 Canadian study reveals that there is no upper age limit for improving aging-related quality of life with ET.[ii]

Until Neuravive was developed, almost all neurosurgeries that involve holes drilled in the skull and hardware inserted into the brain were deemed inappropriate for older-to-elderly people. That’s because these surgeries are invasive and time consuming, and too hard on aging individuals. However, Neuravive has changed all that, as the new report shows.

The paper’s title, Magnetic Resonance-Guided Focused Ultrasound Thalamotomy to Treat Essential Tremor in Nonagenarians, refers to people in their 90s. The word nonagenarians comes from a Latin root word nonaginta, meaning ninety. While it may be hard to imagine someone in their 90s undergoing an intervention on an area deep in the brain, the paper describes the use of Neuravive to treat ET in two individuals older than 90 years.

In both cases, the patients came through safely and tolerated the procedure well. Most importantly, the authors note that the treatment benefited them significantly, since it was able to “… relieve their symptoms and improve their quality of life.” The Canadian team concluded that “… age should not be a limiting factor in the treatment of patients with MRgFUS.”

Brightening the Golden Years with ET

Our Center is grateful to the expert multi-center Canadian neurologists and radiologists who were confident that MRgFUS is safe at virtually any age. We especially acknowledge the courage of the two patients who are the first known 90-year olds to have the Neuravive procedure for ET. It’s truly comforting to know that our Center can expand the “age barrier” in offering Neuravive to those with ET who are otherwise qualified for it.

As the Canadian report shows, you’re never too old to get relief no matter how many years you’ve lived with ET.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

[i] https://www.essentialtremor.org/wp-content/uploads/2019/06/FactSheet062019.pdf
[ii] Paff M, Boutet A, Neudorfer C, Elias GJB et al. Magnetic Resonance-Guided Focused Ultrasound Thalamotomy to Treat Essential Tremor in Nonagenarians. Stereotact Funct Neurosurg. 2020 Mar 30:1-5.

About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Neurosurgery Associates.

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