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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 8999
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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Suffering from ET that has been gradually progressing over

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Suffering from ET that has been gradually progressing over the past 5-7 years (I'm 66 years old and in good health). Hands and head are the main problems. It also seems that it is getting worse after "a hard session in the gym". Not interested in medication but hoping I guess for "something else"
Thank you very much for any thoughts

neuromd2012 :

Hello

neuromd2012 :

I am an Adult Neurologist and will try to answer your question

Customer:

Hello, looking forward to it

neuromd2012 :

hi

neuromd2012 :

so if you are looking for a non-pharmacologic treatment for ET

neuromd2012 :

there is something new that just came out

neuromd2012 :

are you familiar with MRI guided high frequency Ultrasound treatments?

Customer:

No, but I was going to ask if NST could in any way help

neuromd2012 :

what is NST?

Customer:

neuro-structural intergration technique

Customer:

anyway, interested in your idea

neuromd2012 :

HI. I just went to read a little on NST. I really know nothing about it

neuromd2012 :

let me tell you what I know about this

neuromd2012 :

so there is also a new scan out. called a DaT Scan

neuromd2012 :

by GE

neuromd2012 :

it is a SPECT scan

neuromd2012 :

and can measure your dopamine levels in areas of the brain

neuromd2012 :

that pattern the features seen in ET

neuromd2012 :

so it can differentiate ET from Parkinson's

neuromd2012 :

if that is a concern, which it may not be for you

neuromd2012 :

then there was a study by the NIH (national institute of health) out of the Univ. of Virginia

neuromd2012 :

and they came up with this treatment

neuromd2012 :

called MRI guided high frequency ultrasound

neuromd2012 :

using an MRI scanner, they are able to look at parts of your brain that is activated

neuromd2012 :

during the tremor

neuromd2012 :

and then they can use ultrasound stimulation on that specific region (it is in a area of the thalamus)

neuromd2012 :

and reduce your tremor

neuromd2012 :

It is now going through FDA approval

neuromd2012 :

but they are already using it in Europe, and in Canada

neuromd2012 :

the Mayo clinic supposedly has purchased the machinery and is awaiting approval to use it

neuromd2012 :

I will get you some information

neuromd2012 :

hang on

neuromd2012 :

here is one publication in Lancet neurology

neuromd2012 :

http://www.ncbi.nlm.nih.gov/pubmed/23523144

Customer:

OK, sounds promising but possibly also a bit too early to try to "get in on the act"

neuromd2012 :

right

neuromd2012 :

exactly

neuromd2012 :

for you

neuromd2012 :

it may not be reasonable

neuromd2012 :

yet

Customer:

I kind of feel that things get worse after vigorious exercise - is that also typical

neuromd2012 :

it can be in ET, but also in tremor from other causes

neuromd2012 :

like if you have cervical stenosis

neuromd2012 :

degenerative arthritic disease in your neck????

Customer:

hmmm, don't think I have any of that

neuromd2012 :

you should have neck pain in that setting, and a restriction in range of motion of the cervical spine

Customer:

doesn't sound like me

neuromd2012 :

ok

neuromd2012 :

so you have tried meds? like inderal, and mysoline? or not interested

Customer:

not really interested in meds

neuromd2012 :

well that is about all I have on ET

Customer:

ok, I am very appreciative. Bottomline though seems to be to hurry up and wait for FDA etc and the new approach - any thoughts on timing (which is always a big ??? with FDA

neuromd2012 :

they really can take for ever. I am waiting for publications to come out from the clinics in Europe and toronto

neuromd2012 :

where they are doing patient daily.

Customer:

ok, thanks again for your advice, really appreciate it

neuromd2012 :

I have seen some cases, where there was a really bad tremor, that was resolved

neuromd2012 :

sure

neuromd2012 :

good luck

neuromd2012 :

Dr Frank T

neuromd2012 :

bye

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