Essential tremor is common, thought to affect 1 in 10 people over the age of 70, and may be severe, causing significant functional disability. It is difficult to treat. Available medications reduce tremor only partly and do not work in a significant number of patients. Further, they may have adverse effects. They include mainly beta-blockers, primidone, and topiramate or zonisamide, used off-label. Deep brain stimulation is very effective but is obviously invasive, with attendant risks.
Now, a new device has just received FDA approval. It is termed ExAblate Neuro system. Using ultrasound waves, it could ablate the target brain tissue. The study was randomized, double blind, with 76 patients who received the ExAblate treatment or a sham procedure. Placebo patients were later allowed to “cross over.”
Treated patients had an almost 50% improvement in tremor severity and function.