Editing Essential tremor (section)

====Ultrasound====
[[File:MRI-guided HIFU, essential tremor, 10-14 135, pointed.png|thumb|Frontal MRI four days after MRgFUS (MRI-guided high-intensity focused ultrasound): Left ventral intermediate nucleus (Vim) thalamotomy. 79-year-old man with essential tremor.]]
Additionally, [[MRI]]-guided [[high-intensity focused ultrasound]] is a nonsurgical treatment option for people with essential tremor who are medication refractory.<ref name=pmid28503363>{{cite journal | vauthors = Rohani M, Fasano A | title = Focused Ultrasound for Essential Tremor: Review of the Evidence and Discussion of Current Hurdles | journal = Tremor and Other Hyperkinetic Movements | volume = 7 | pages = 462 | year = 2017 | pmid = 28503363 | pmc = 5425801 | doi = 10.7916/D8Z89JN1 | doi-broken-date = 25 February 2025 }}</ref><ref name=FDA2016>{{cite press release |title=FDA approves first MRI-guided focused ultrasound device to treat essential tremor |url=https://www.fda.gov/news-events/press-announcements/fda-approves-first-mri-guided-focused-ultrasound-device-treat-essential-tremor |publisher=FDA |date=24 March 2020 }}</ref> MRI-guided high-intensity focused ultrasound does not achieve healing, but can improve the quality of life by reducing the tremor manifestation.<ref name=FDA2016 /><ref>{{cite journal|date=2023|volume=9|issue=1|pages=17–20|doi=10.1515/cdbme-2023-1005|vauthors=Aharonson V, Postema M, Gebbie R, Van Der Merwe J, Schlesinger I|title=Sobel edge detection for quantifying the effectiveness of focused ultrasound thalamotomy for tremor relief|journal=Current Directions in Biomedical Engineering|doi-access=free}}</ref> While its long-term effects are not yet established, the improvement in tremor score from baseline was durable at 1 year and 2 years following the treatment.<ref name=pmid29265546>{{cite journal | vauthors = Chang JW, Park CK, Lipsman N, Schwartz ML, Ghanouni P, Henderson JM, Gwinn R, Witt J, Tierney TS, Cosgrove GR, Shah BB, Abe K, Taira T, Lozano AM, Eisenberg HM, Fishman PS, Elias WJ | title = A prospective trial of magnetic resonance-guided focused ultrasound thalamotomy for essential tremor: Results at the 2-year follow-up | journal = Annals of Neurology | volume = 83 | issue = 1 | pages = 107–114 | date = January 2018 | pmid = 29265546 | doi = 10.1002/ana.25126 | s2cid = 4437809 }}</ref> To date, reported adverse events and side effects have been mild to moderate. Possible adverse events include gait difficulties, balance disturbances, [[paresthesia]]s, [[headache]], skin burns with ulcerations, skin retraction, scars, and blood clots.<ref name=pmid28503363/><ref name="FDA2016" /><ref name="Hedera2017">{{cite journal | vauthors = Hedera P | title = Emerging strategies in the management of essential tremor | journal = Therapeutic Advances in Neurological Disorders | volume = 10 | issue = 2 | pages = 137–148 | date = February 2017 | pmid = 28382111 | pmc = 5367648 | doi = 10.1177/1756285616679123 | type = Review }}</ref> This procedure is contraindicated in pregnant women, persons who have non-MRI compatible implanted metallic devices, allergy to MR contrast agents, cerebrovascular disease, abnormal bleeding, hemorrhage and/or blood clotting disorders, advanced kidney disease or on dialysis, heart conditions, severe hypertension, and ethanol or substance abuse, among others.<ref name="FDA2016" /> The US Food and Drug Administration ([[Food and Drug Administration|FDA]]) approved Insightec's Exablate Neuro system to treat essential tremor in 2016.<ref name="FDA2016" />