‘My Shaking is Down to Zero’ -- Patient Undergoes Milestone 2nd High-Intensity Focused Ultrasound (HiFU) for Essential Tremor

There are two sides to everything, as the expression goes. And that now applies to HiFU (High-Intensity Focused Ultrasound) procedure. HiFU offers an incisionless outpatient procedure for patients with essential tremor or Parkinson’s disease who don’t get acceptable tremor relief from medications.

The U.S. Food and Drug Administration (FDA) last year approved applying this advanced procedure to both sides of a patient’s brain, enabling even more extensive success in eliminating tremors with minimal side effects. Just ask Andrés Sosa, 75, who started noticing involuntary shaking in both hands about 12 years ago.

He would become a patient of Justin Sporrer, M.D., neurosurgeon and director of functional neurosurgery at Baptist Health Miami Neuroscience Institute, who has presided over more than 100 HiFU treatments at the Institute. Mr. Sosa was the 100^th patient.

(Watch video: Hear from patient Andrés Sosa, his wife Anna, and Justin Sporrer, M.D., neurosurgeon and director of functional neurosurgery at Baptist Health Miami Neuroscience Institute.)

“I felt as if I had been born again,” says Mr. Sosa, who underwent HiFU on each hand, one year apart. “Something I hadn’t been able to do for many years — writing — I started doing again. I started writing as children do. I feel very happy to have been the 100^th (HiFU) patient for Baptist Health. The shaking is down to zero. I feel very good. I thank God and the doctor for what he did for me.”

Abnormal electrical activity deep in your brain causes essential tremor. HiFU therapy uses image-guided ultrasound to deliver ultrasound energy to the area of your brain where this abnormal electrical activity is happening. HIFU emits energy that is similar to that used for diagnostic imaging, but the ultrasound waves carry much higher intensity. The ultrasound energy destroys the cells causing the abnormal electrical activity.

“Through our experience and through Baptist's investment in this technology, we have been able to treat over 100 patients,” explains Dr. Sporrer. “Which believe it or not, is actually a very high volume when you compare that nationwide. (Mr. Sosa) came back because his other side still had tremor. We finally got the FDA approval to treat somebody on both sides with high-intensity focused ultrasound. That's a huge win for this patient population because before that, you could only get it on one side ever during your life.”

Justin Sporrer, M.D., director of functional neurosurgery at Baptist Health Miami Neuroscience Institute.

During HiFU you will be inside an MRI scanner, allowing the neurosurgeon to target the exact area in your brain with abnormal electrical activity. Essentially,  the same ablation that is done during tradition surgery can be accomplished with no incisions After HiFU treatment, a patient should feel tremor symptoms subside immediately. “We're able to disrupt an abnormal circuit that exists in some people who have Parkinson's disease or essential tremor or other movement disorders,” said Dr. Sporrer.

Recalls Mr. Sosa’s wife, Anna: “When we received the call from Dr. Sporrer's office that the FDA had actually given clearance to do a second HIFU procedure on the same patient. For us, it was really a sense of excitement. Today, he is doing amazing. Neither hand shakes, and he is able to button his shirts and shave.”

Mr. Sosa is a retired mechanic and machinist who had worked for several manufacturers. His dexterity was a key part of his work. “When my hands started shaking, I thought it was due to muscle fatigue. Because my work involved using a microscope and handling things with my hands, I thought my muscles were getting tired.”

“When I first started to notice this, I was not very concerned,” recalls Anna Sosa. “I mean, it's one of those things that you just look at and you go, "Hmm." And you keep going.” But his condition became progressively more noticeable and debilitating.

“This change in lifestyle gradually became more difficult because I was afraid of just leaving him alone when I went off to work,” she said. “Not because he couldn't take care of himself, but I was afraid he would do something that would cause him to hurt himself by virtue of not having the dexterity that he needed and the tremors.”

Mr. Sosa went to neurosurgeons outside of Baptist Health who diagnosed him with tremors. He said he was prescribed medications over time that were not effective. Mr. Sosa was eventually referred to Dr. Sporrer.

“From the moment I entered the operating room (for the first HiFU procedure, everything was amazing,” recalls Mr. Sosa. “To me, the treatment is incredible. I recommend it to everyone. They should find out whether they are a candidate for this treatment.”