Today we will talk about treating Essential Tremor with Gamma Knife Radiosurgery.
Essential Tremor is the most common movement disorder, in fact more common than Parkinson's disease
Over 10 million Americans are affected and is hereditary 60% of the time.
Men and women are equally at risk for essential tremor.
Unlike Parkinson's Disease, Essential Tremor is an action tremor, most commonly involving the upper extremities, including the hands and arms.
The uncontrollable shaking impacts daily activities like writing, drinking or dialing a telephone.
The cause of essential tremor is located deep within the brain.
We have a left and a right thalamus, each is about the size of a walnut and only a small part of the thalamus, called the Ventral Intermediate Nucleus or VIM, is the cause for the tremor.
The VIM is about the size of a pea.
Tremors on the right side of the body are caused by overactive brain cells in the left thalamus and vice versa.
The good news is there are treatment options to help reduce or eliminate the tremor.
Over time, the pharmaceutical approach may become ineffective and other options will be considered.
The surgical approach is called Deep Brain Stimulation.
Neurosurgeons implant tiny electrodes into the brain to control the tremor.
The procedure can be reversed and the tremor control is nearly instantaneous.
Another option is Stereotactic Radiosurgery which sounds like surgery but there are no scalpels or operating rooms.
The Gamma Knife delivers radiation to a small target.
The Gamma Knife delivers radiation to the tremor causing brain cells during this outpatient procedure.
Only at the target is the radiation dose strong enough to kill these cells while preserving the surrounding healthy tissue.
This is a non-invasive treatment completed during a single visit and no general anesthesia is needed.
There are few if any side effects and Gamma Knife is suitable for anyone suffering from Essential Tremor & especially for those medically unfit for the surgical option.
Results are typically seen 3 to 6 months after treatment.
The treatment day has a series of steps for the patient and is guided by our experienced Gamma Knife team.
The team consists of the neurosurgeon, radiation oncologist, physicist, nurses and support staff.
Gamma Knife patients arrive at the Swedish Radiosurgery Center and meet with our nurses who go over the steps and answer questions.
A mild sedative is given to help the patient relax.
Several imaging studies of the brain will be done to provide the physicians and physicists the information they need to develop the treatment plan.
The head frame placement is the step many patients feel anxious about
The frame is attached to the patient's head by the neurosurgeon
Local anesthetic is injected before the four pins are inserted to hold the frame in place.
The frame is necessary to guarantee pinpoint accuracy when delivering the radiation.
The imaging studies are completed and a clear helmet is attached to the frame for a series of measurements.
The physicist is given this additional data to develop the customized treatment plan.
Our experienced team is led by neurosurgeon, Dr Ron Young who pioneered the use of Gamma Knife for essential tremor and has treated over 1000 patients.
Together the radiation oncologist, neurosurgeon and physicist identify the target and visualize critical structures nearby and the treatment plan is finalized.
During treatment the patient will lay on his or her back with the head frame secured to the Gamma Knife.
The patient will be alone in the treatment room but able to communicate with the team who provides verbal updates throughout the procedure.
The Gamma Knife has 192 beams of radiation which intersect at the target.
No single beam has enough radiation to cause damage to healthy brain tissue through which it travels and the point at which the beams meet is where the optimal dose is delivered to kill the tremor causing cells.
When the treatment is over, the frame is removed and the patient returns home.
More than one patient has said, brain surgery in the morning, home for dinner that night.
Following the Gamma Knife treatment, patients experience few if any side effects.
Results are gradual and generally observed within 3 to 6 months.
Over 80% of patients report reduced shaking and many are completely tremor free.
For those who suffer from tremors on both the left and right side, a second Gamma Knife procedure can be done following a waiting period.
People with essential tremor often suffer in silence and many don't realize there are treatment options.
Please share this with those who might benefit and please let us know if you have questions or need additional information.
Our phone number is 206-320-7130 or you can find additional information at wwww.swedish.org/gammaknife.