In many cases, we associate the passage of life with the appearance of numerous pathologies. However, having a birthday increases the risk, but does not necessarily mean suffering from a condition such as essential tremor. In other words, a person ends up suffering from a tremor because they develop the problem, not because they are older.
Essential tremor, the most common movement disorder, affects 6% of people over 60 years of age, although, as we have already mentioned, it can appear at a very early age. In fact, patients often state that they live with it for years and that it increases with age, affecting their daily activities.
It is not a neurodegenerative disease but is caused by dysfunction of the neural circuits involved in movement. It usually occurs in several family members, so there is a hereditary factor, but specific genes in most cases have not yet been discovered.
Appears in the hands when performing an action, although it may be more serious in one of them. If the tremor is severe enough, it may be difficult for the patient to perform daily tasks such as writing, holding a glass of water without spilling it, handling cutlery while eating, brushing teeth, applying makeup, shaving, tying buttons or zippers, putting on earrings, etc. .P. Some people may also experience voice or head tremors.
Thus, it is a pathology that can greatly affect the quality of life if it reaches a significant intensity. That is why it is important to look for an individual solution to this problem.
Tremor is caused by malfunction of neurons in the nucleus of the brain (ventral intermediate nucleus of the thalamus) involved in movement. In these neurons, the excitation pattern necessary for proper movement is replaced by oscillatory activity that is superimposed on the entire motor circuit. This causes the hands to shake at the same frequency as the oscillatory activity of these neurons when they are about to perform an action.
Although it is not known exactly what triggers it, the available data indicate that there is a violation of the cerebellar activity of neurons in the ventral intermediate nucleus of the thalamus.
Thus, this is a situation different from other pathologies that occur with tremor, in the case of degenerative diseases such as Parkinson’s disease. In this disease, the tremor that usually occurs at rest is due to the progressive death of neurons that produce dopamine, a neurotransmitter responsible for motor circuit modulation and normal movement. In addition to tremor, Parkinson’s patients suffer from other disorders such as clumsiness, rigidity, etc.
HIFU, a treatment that allows you to control tremors
When a patient has essential tremor, the goal is to get their motor circuitry back to normal. Therefore, the treatment is aimed at restoring the pattern of neuronal activity so that the execution of the movement is correct.
The main methods of treatment for this pathology were beta-blockers and antiepileptic drugs. However, its use is usually not enough to improve the patient’s quality of life.
Fortunately, we can now resort to the HIFU system, a high-intensity focused ultrasound device that allows us to traumatize, without open skull surgery, the affected neurons in the ventral intermediate nucleus of the thalamus, which is a deep structure of the thalamus, in a controlled manner. brain. This method allows access to many patients because it is minimally invasive.
To perform the procedure, the first step is to shave the patient’s hair and attach a frame to his head, which will attach it to the MRI where the treatment is being performed. When you lie down on the MRI table, a membrane is also placed over your head through which very cold water circulates to cool the scalp and prevent the ultrasound from overheating the skin. The intervening person is awake at all times, cooperating with professionals during the intervention.
The ultrasound focuses on the part of the brain where the neurons we want to remove are located. Radiating increasing energy, it is converted into heat to heat the tissue in the target area and perform the lesion. As the temperature rises, the tremor gradually disappears, confirming that we are aiming at the right place. Once this result is obtained, the power of the energy is increased to reach a temperature that causes irreversible damage to the neurons and the final improvement of the tremor.
One of the biggest benefits of this procedure is that improvement in tremor usually occurs immediately. Given that the patient does not need prior hospitalization, they can be discharged 24 hours after undergoing HIFU.
It is true that, as with any treatment, there may be some side effects. But they are usually associated with the appearance of swelling around the injured area, which disappears after a short time. Therefore, the patient usually shows a high degree of satisfaction after the intervention. Don’t accept that you are living with essential tremor.