Devin K. Binder, M.D., Ph.D., is using the latest technology for MR-guided Focused Ultrasound procedures on a patient.

Deep in the brain lies a tiny structure called the ventral intermediate (VIM) nucleus. Part of a larger structure, known as the thalamus, the VIM nucleus has been identified as the source for treatment of essential tremor, a neurological condition that affects nearly 10 million Americans.

Essential tremor causes uncontrollable shaking of one or both hands and may also affect the head, voice, torso and legs. For some, the shaking is constant and debilitating, interfering with everyday activities, such as dressing, eating and drinking, and writing.

Medications have been developed to treat essential tremor but can be ineffective or have unwanted side effects. If patients are unresponsive to medication or other traditional treatments and have been differentially diagnosed as suffering from essential tremor, they can receive a comprehensive evaluation to determine if they are a candidate for magnetic resonance (MR)-guided Focused Ultrasound, an incisionless procedure that can reduce or eliminate the tremor.

What is MR-guided Focused Ultrasound?

MR-guided Focused Ultrasound combines two advanced technologies: focused ultrasound and magnetic resonance imaging (MRI). MRI delivers real-time 3D images of the patient’s brain that allow the neurosurgeon to target the VIM nucleus and accurately deliver simultaneous beams of ultrasound. The beams pass through the skin and skull to intersect at the targeted location, heating the tissue and creating a small burn, called an ablation, which provides a therapeutic effect.

The patient is awake and actively participating in their treatment. Before the procedure, we evaluate the severity of their tremor through simple tasks, such as handwriting, holding a cup, or drawing spiral diagrams. We have them repeat these tests periodically and continue with the procedure until their tremor has been suppressed.

Devin K. Binder, M.D., Ph.D., neurosurgeon at Orange Coast Medical Center

The outcomes of this two-hour procedure are immediate. Often, patients who could not hold a fork or pen in their dominant hand prior to the procedure are able to eat independently and sign their names clearly afterward. With no incisions involved in the treatment, recovery times are quicker than a traditional neurological surgery, and patients are able to resume normal activities within a few days.

Flagship program

Orange Coast Medical Center is one of only two hospitals in Southern California to offer MR-guided Focused Ultrasound for intervention of essential tremor. The treatment is covered by Medicare, making it more accessible for patients who need it.

Tremor reduction is immediate and life-changing with this procedure. Patients are able to regain their independence, which improves the quality of their life.

Theresa Stern, M.P.T.

Director of the MemorialCare Neuroscience Institute at Orange Coast Medical Center

​For more information on the MR-guided Focused Ultrasound Program at Orange Coast Medical Center, please visit