Q: How is the man doing who had a new ultrasound procedure to treat essential tremor? Is he still free of tremors?
A: Richmond Times-Dispatch staff writer Karin Kapsidelis wrote in March about Billy R. Williams, who in February was treated at the University of Virginia for essential tremor, a disorder in which people suffer involuntary, uncontrollable tremors or shakes.
"Everything for me has worked out almost perfect," Williams, 74, said recently in a telephone interview
"I can write my name still. I can tee golf balls up. I can eat without spilling. It's really nice to be able to do that after 10 years of shakes and tremors," said Williams, who lives in Fort Valley.
Williams had a treatment called MR-guided focused ultrasound in which doctors used magnetic resonance imaging to identify areas of the brain's thalamus associated with tremors. They then blasted those areas with intense concentrated sound waves to burn away tissue.
The treatment is noninvasive; doctors don't have to drill holes in the skull, as they do in other deep-brain stimulation procedures. Patients remain awake during the treatment and are asked to respond to commands so doctors can determine if they are targeting the right areas.
Dr. W. Jeffrey Elias, a neurosurgeon at U.Va., said Williams has completed the three-month study period.
"We are still following him," Elias said. Williams said he goes back in February for a one-year follow-up visit.
"He has done very well with excellent tremor control, sustained throughout the study period. He didn't have any kind of adverse effects from the procedure," Elias said.
Doctors don't know what triggers the tremors, which can interfere with working, eating and drinking. In some cases, there is a genetic link. Actress Katharine Hepburn had the disorder.
Williams was treated as part of a clinical research study. Elias is lead investigator for the study, which is approved by the U.S. Food and Drug Administration. The study is a phase one trial to determine the safety and effectiveness of the procedure. The university's institutional review board provides oversight.
Elias said three additional patients have been treated as part of the study. So far, the results have been similar to Williams', he said.
"We are going to enroll 15. We have more patients planned for this year, this summer," Elias said. "Almost after each case or event, we update the review board. We are very pleased with the initial results and continue forward.
"If this phase one study proves to be safe, then we will proceed with a larger pivotal study in an effort to make the treatment available for widespread application," Elias said.
As estimated 10 million Americans have essential tremor.
"This condition can occur at any age, although it is seen more often in older adults. It is as common as Parkinson's disease," said Mary Maiden, who helps coordinate Richmond Essential Tremor Support Group meetings.
The support group meets monthly at Our Lady of Hope Health Center, 13700 N. Gayton Road. Details are at EssentialTremor.org/Events.
Focused ultrasound is approved by the FDA to treat uterine fibroids and also is being studied as a treatment for prostate tumors, low-back pain, palliative pain treatment in bone-cancer patients, and face-lifts and other body contouring.
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