High-Intensity Focused Ultrasound for Tremor

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Severe tremor (shaking) can make everyday tasks exhausting and frustrating. Simple things, like eating a bowl of soup or tying your shoes, suddenly aren’t so simple.

If you have essential tremor or tremor-dominant Parkinson’s disease that make your daily life challenging, there’s hope. High-Intensity focused ultrasound (HIFU) can be a life-changing, minimally invasive treatment option. By using concentrated ultrasound waves to heat your brain tissue and block signals that cause tremor, experts can help with symptoms. You’ll often see results right away. And little things, like drinking a glass of water, are easier.

Our Cleveland Clinic specialists will work as a team to design a treatment plan that matches your needs. If HIFU is a good option, they’ll guide you through the entire process.

Why Choose Cleveland Clinic for High-Intensity Focused Ultrasound?

Trusted experts:

Our team includes expert neurologists and neurosurgeons who are fellowship-trained in stereotactic neurosurgery (image-guided brain and spine surgery) and functional neurosurgery (restores how your nervous system works). Cleveland Clinic neuroradiologists (specialists in imaging of your head and neck) have extensive training in HIFU techniques. Meet our team.

Specialized equipment:

Our experts use advanced software-guided ultrasound systems to give you precise treatments. Having the best tools available is an important part of your care. Our experts use advanced software-guided ultrasound systems to give you precise treatments.

Caring approach:

We understand that tremor symptoms affect every part of your life and can prevent you from taking care of yourself and those you love. Our compassionate specialists make sure you have the information you need to make decisions about your treatment.

Virtual visits:

We want to make care as convenient as possible for you. That’s why we sometimes offer virtual visits in addition to in-person appointments. Your provider will meet with you online using a smartphone, tablet or computer.

National recognition:

Cleveland Clinic is a trusted healthcare leader. We're recognized in the U.S. and throughout the world for our expertise and care.

HIFU Treatment at Cleveland Clinic

Hearing that we can treat your tremor by using heat to purposely damage parts of your brain might make you nervous. But rest assured that our expert neurosurgeons and neuroradiologists use HIFU in a safe and targeted way to help block signals that cause your tremor.

The U.S. Food and Drug Administration (FDA) has approved HIFU to treat essential tremor and tremor-dominant Parkinson’s disease in certain people. Experts can use HIFU to treat tremor on both sides of your body.

Preparing for HIFU

As a part of the planning process, we may ask you to draw or write so we can see how tremor affects your abilities.

Just before the HIFU procedure, we:

Shave your head.
Place your head inside a frame to hold your head still.
Apply a silicone mask to your head to keep your scalp cool.
Bathe your scalp in cold water.

We may give you medication to lightly sedate you, but you’ll be awake throughout the procedure. After we position your head in the frame, we move you into an MRI bed. We take several pictures to precisely identify the part of your brain we’ll treat.

HIFU treatment typically takes between two and four hours. Providers talk with you during the procedure.

Our experts do HIFU in three stages:

Alignment

Neurosurgeons and neuroradiologists position the ultrasound device to send high-frequency sound waves to the targets in your brain. We use MRI to make sure we’ve positioned the beam in exactly the right spot. We start the procedure with low-energy pulses to be sure the targeted location is getting treatment.

Verification

In real-time, we confirm the tremor is getting better. We talk with you to make sure you’re comfortable, and we take more pictures using MRI. We may ask you to move in certain ways or to write or draw to see how your tremor responds.

HIFU treatment

During treatment, we’ll raise the temperature of the ultrasound waves to deliver a full dose. We continue to take pictures and check the temperature of your brain tissue. Our specialists make changes to the waves based on your tremor symptoms.

Providers Who Perform High Intensity Focused Ultrasound

Locations

Our healthcare providers see patients at the following location in Northeast Ohio.

Benefits and Risks of High-Intensity Focused Ultrasound

There are many benefits to HIFU. With this treatment option, specialists don’t make any incisions (cuts) or implant any devices. There’s no risk of infection and experts can see how your tremor responds during the procedure.

Your tremor may improve after HIFU treatment but come back later. After the procedure, you may experience side effects, such as:

Balance problems.
Headaches.
Nausea.
Numbness.
Problems with speech (such as spasmodic dysphonia) and swallowing (dysphagia).

HIFU doesn’t cure essential tremor or tremors from tremor-dominant Parkinson’s disease. But the treatment may improve your symptoms and help you stay independent.

Taking the Next Step

Tremor symptoms can affect even the smallest parts of your daily life. But you don’t have to just live with them. High-intensity focused ultrasound is a treatment option that can be a game-changer. Our experts can work together to create a specialized treatment plan for you and help get you back to enjoying life.