For testing effectiveness and safety, the patient must be conscious and able to report their sensations, as well as follow instructions and commands. For example, as soon as the final stage of treatment begins, we can assess its effectiveness by asking the patient to do things like write their name or draw a spiral. As the tremor gradually disappears, the doctor and patient can see the results immediately during therapy. When the tremor is fully controlled, the treatment is complete. The patient can dress and go home.
Therefore, we use local anesthesia at the fixation points of the stereotactic frame (frontal and occipital protuberances), which does not affect the severity of the tremor. The brain does not have pain receptors, so ultrasound exposure rarely causes significant pain sensations. Short-term neurological manifestations may occur, such as a sensation of flipping or swaying of the body in space. With high bone density of the skull vault, higher ultrasound energy is required, which may cause nausea. In this case, antiemetic drugs are used (as needed), and an electric suction device is always ready.
Some patients report a feeling of pressure from the silicone membrane that encloses the space where water circulates. This factor cannot be eliminated, as a loose fit of the membrane would cause leaks.
Thus, the procedure is quite tolerable, although it requires psychological preparation from the patient, as with any surgery.
More about the treatment of tremor and Parkinson’s disease with focused ultrasound
Doctor - Obstetrician-Gynecologist, Ultrasound Diagnostics Doctor