MRG FUS – modern treatment of essential tremor and the tremor form of Parkinson's disease using concentrated sound waves
Essential tremor (ET) ) is very distressing and debilitating. For people suffering from this condition, the symptoms make daily functioning difficult and prevent even simple activities such as writing, drinking a glass of water or using a touch-screen phone. Unfortunately, pharmacological therapy often does not bring results, while surgical brain operations carry the risk of complications.
MRG FUS is a new treatment for essential tremor.Surgery without opening the skull. By choosing Medicover Hospital, you have a chance to regain control over your life.
MRG FUS (Focused ultrasound surgery)
Medicover Hospital has the most advanced system in the world - Exablate Neuro by Insightec. The focused ultrasound beam enables the treatment of essential tremor and Parkinson's disease. The treatments are characterized by exceptional precision and effectiveness.
The procedures are performed by an outstanding, world-renowned neurosurgeon - Professor Mirosław Ząbek who was the first in Poland to perform many unique operations, such as: implantation of a brain stimulator in the treatment of dystonia, essential tremor, Parkinson's disease, and Tourette's syndrome
Brain surgery with a focused ultrasound beam under mri control – MRg FUS
MRg FUS is a therapy method for patients who are not pharmacologically treated.
The therapy uses focused sound waves that reach the brain. The treatment is performed under the control of magnetic resonance, which allows the doctor to designate and reach the treatment area. The doctor, with the help of ultrasound, improves the brain function that is responsible for the tremors. Ultrasounds heat the tissue, first in a reversible way, and after assessing the effectiveness of the treatment and checking whether there are any side effects, ablation is performed, bringing relief to the patient. The patient remains conscious during the procedure. The procedure takes only a few hours, and the symptoms of the disease begin to subside almost immediately.
Benefits
Immediate improvement in the presence of tremor
Non-invasive without opening the skull
Quick recovery within a few days after the procedure the patient can return to normal activity
Zero risk of infection due to lack of physical interference
Results
In clinical trials, patients reported an average improvement in tremor elimination of 76.5% (source: Insightec clinical trials). Patients who were unable to write or drink a glass of water without spillage before the procedure were able to perform these simple daily activities immediately after.
Due to the minimal invasiveness of the procedure and the lack of general anaesthesia, the patient can usually return home after one day and perform daily activities.
Your health will be taken care of by renowned, experienced doctors
Prof. Miroslaw Ząbek MD PhD Hab
Paweł Gutowski MD PhD
Mikołaj Raźniak MD
Prof. Miroslaw Ząbek MD PhD Hab
Professor of neurosurgery, an outstanding expert renowned around the world.
Graduate of the Warsaw Medical Academy. He completed the European Neurosurgical Training (1987-1991) as well as individual neurosurgical training internships in Finland, Germany, Sweden, Italy, Spain, France, the United States, Belgium and Japan. He completed European training in the field of vertebroplasty, kyphoplasty, surgery and arthroplasty of the cervical and lumbar spine, minimally invasive spine surgeries.
Head of the Department of Neurosurgery of the CMKP, founder and director of the Gamma Knife Center and founder and manager of the Intervention Center for Neurotherapy. Chairman of the University Council of the University of Warsaw. An expert at the Medical Research Agency, and at Bródno Hospital he is the coordinator of the Department of Neurosurgery. For 10 years he served as the country's consultant for neurosurgery. Professor Ząbek is the only one in Poland who performs treatments using the MRg-FUS method.
Paweł Gutowski MD PhD
Neurosurgeon. Graduate of the Ludwik Rydygier Collegium Medicum in Bydgoszcz, part of the Nicolaus Copernicus University.
He gained his specialisation in Berlin, where he practiced at the Department of Neurosurgery at Berlin Hospital for 8 years. He defended his doctorate in 2016 at the Charité Hospital - Universitätsmedizin in Berlin. From 2020, he works with Prof. Miroslaw Ząbek.
Mikołaj Raźniak MD
Neurosurgeon. Graduate of the 1st Faculty of Medicine of the Medical University of Warsaw.
Assistant at the Department of Neurosurgery of the Mazowiecki Bródno Hospital. Dr Raźniak mainly deals with functional neurosurgery, spine surgery and neurooncology. He is a member of Prof. Miroslaw Ząbek’s team.
Essential tremor and Parkinson's disease
Essential tremor, like Parkinson's disease, is a neurological disorder that causes tremors in the hands, head, and in some cases, the legs and trunk. It can develop in a person at any age, but most often it appears in the 20’s and 60’s.
Symptoms (develop gradually, and their increase depends on previously unknown factors):
uncontrollable shaking that occurs for short periods of time
it starts gradually, usually on one side of the body
tremor of the hands is the most common, but may include tremor of the voice or head
nodding
it intensifies in moments of stress and targeted movement
Q&A
What tests should be performed and what qualifications for treatment with the MRI FUS method should be completed?
The following tests will be needed in the process of qualifying for treatment:
Neurological assessment:
verbal-logical contact
spontaneous speech
speech flow
articulation
voice perception test
aerodynamic test
assessment of phonation efficiency
assessment of swallowing disorders
assessment of handwriting disorders
severity of speech disorders
GRBAS scale
Neuropsychological assessment:
MOCA or MMSE (must be uniform for all assessments)
CLOX scale
ACE-III scale
AVLT or CVLT scale (must be uniform for all assessments)
Tower of London scale
Benton JLO scale
Connecting Points A and B Test
WAIS-R scale (selected minimum 2-3 parts unified for all)
BNT scale
BDI-II scale
BAI scale
Computed tomography of the head – performed at Medicover Hospital at the request of a doctor. On the same day, it is possible to qualify for the MRg FUS procedure.
Magnetic resonance imaging of the head (the test must be performed within the last 12 months at most).
Levodopa test: if not performed (Parkinson's patients only).
The above examinations can be performed at Medicover with the help of a dedicated Medicover patient's representative. The final qualification for the MRg FUS procedure is made by a team of neurosurgeons led by Prof. M. Ząbek.
After taking into account the test results, the doctor orders further diagnostics in order to obtain a final decision.
How do you prepare for the procedure?
After obtaining the final qualification, the patient will undergo a CT scan of the head to analyse the areas responsible for the tremor. In order to avoid the dispersion of sound waves, it is necessary to shave the head, which is performed at the hospital, immediately before the procedure.
How is the procedure performed?
Immediately before the procedure, an anaesthetic will be applied locally, and a special frame will be attached to the head, which stabilizes the patient's head during the procedure.
Your heart rate, blood pressure and blood oxygen levels will be monitored throughout the procedure. The patient will remain awake to communicate with the treatment team throughout the procedure. In case of discomfort, additional medications may be administered.
Cool water will circulate in the helmet on top of the head, and the staff will make sure that the patient is not cold. The patient will also receive a special button that can be used at any time to interrupt the procedure for any reason.
After each dose of energy, known as sonication, the doctor will ask you to complete certain tasks to assess your improvement in tremor. These tasks may include, for example, touching your nose with your finger or drawing a spiral.
What are the contraindications?
If you have metal implants, such as pacemakers, neurostimulators, spine or bone stabilizing devices, total joint prostheses, metal clips, screws, etc., it is important that the patient has detailed information about the implanted devices in terms of the ability to perform an MRI.
In addition, if the patient's health condition makes it impossible to lie still in the same position for several hours, this may be a contraindication to the procedure.
In each case, the final decision on qualification for treatment is made by the doctor.
You can reach us by public transport by bus line 217 or 522. The bus stop (Branickiego) is located approx. 50 m from the hospital. GPS 52.15513 N, 21.07863 E, 52'9'18 N, 21'4'43 E
Address
Medicover Hospital al. Rzeczypospolitej 5 02-972 Warsaw (Wilanów Town)
Dear Patients, we would like to inform you that the three-level car park located opposite the entrance to the hospital, has narrow passages. Therefore, manoeuvring, especially with larger vehicles, can be difficult. In such a situation, we encourage you to use the outdoor car park, which has 117 parking spaces and is located at the back of the building.
