Are You In Doubt
– if you would be a suitable candidate for treatment of your tremors, then you are welcome to contact us.
During the pre-outpatient visit with us, our neurologists will assess whether your current medical treatment is optimal. If you are not receiving optimal medical treatment for your essential tremor / Parkinson’s, we can offer a course with optimization of medication before possible treatment with focused ultrasound.
At OUH, he works primarily with surgical treatment of patients with tumors in the brain and skull as well as with research and development within neurosurgical disorders.
In 2001, Frantz completed his education as a doctor from the University of Southern Denmark. In parallel with his medical studies, Frantz has been associated with the University of Southern Denmark as a student researcher in brain research, and after completing his medical studies, Frantz took his PhD degree in experimental neurobiology. After completing his PhD, Frantz was employed at the University of Southern Denmark as a researcher and lecturer.
Frantz took medical training at Fredericia Hospital and in a medical practice in Kolding. Since 2005, Frantz has been employed in neurosurgery at Odense and Aarhus University Hospital.
What Are The Benefits Of Medicare
What services are covered by Medicare? Beneficiaries of Medicare have access to a variety of services, including doctor appointments, hospital stays, medical tests and equipment, and home health care. Beneficiaries may also receive coverage for care related to chronic conditions such as diabetes and heart disease. What are Medicare limitations? What would make it a burden? There are some limitations to Medicare. Nursing homes and long-term care facilities, for example, are not covered. It does not cover the cost of any prescription drugs. What is medicare? Medicare provides a number of benefits, including access to preventative care, such as screenings for cancer and heart disease, and the treatment of chronic conditions. Medicare also provides assistance with the cost of prescription drugs and other medical care for those who qualify. How can I get a clear answer on whether I am covered by Medicare? If you are unsure if you are covered by Medicare, you can contact the Medicare call center at 1-800-633-4327 . Here, you can learn whether you are eligible for Medicare coverage, as well as get information on how to enroll in the program.
First Hospital Based Focused Ultrasound Incisionless Procedure For Parkinsons & Essential Tremors In The Region Takes Place At Delray Medical Center
Dr. Lloyd Zucker, neurosurgeon and medical director of neurosurgery, completes first case
Delray Beach, FL Delray Medical Center is now the first hospital in the region to treat a patient with the new MR-guided focused ultrasound by INSIGHTEC. This technology is a scalpel-free treatment for essential tremor and medication-refractory tremor-dominant Parkinsons disease. This device uses sound wave energy to treat brain tissue as the source of the tremor and there is no surgical incision or anesthesia necessary.
I am honored to be able to not only treat the first patient at Delray Medical Center with this new groundbreaking procedure, but the first in any hospital in the region. We are now able to give those who suffer from this disease a chance to get back to living their lives, and pursuing their daily activities, said Dr. Lloyd Zucker, medical director of neurosurgery for Delray Medical Center. We are at an exciting time in medicine when it comes to treating neuro-disorders, and this technology is a game changer for patients who have suffered from Parkinsons disease.
The MR-guided focused ultrasound combines two technologies, magnetic resonance imaging , which pinpoints the exact location in the brain responsible for the tremor, and ultrasound, which precisely delivers over 1,000 highly focused beams of acoustic energy at that exact location without damaging any surrounding brain tissue.
Some of the benefits to this technology include:
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Low Intensity Focused Ultrasound To Help Deliver Therapies
While high intensity FUS is a treatment for PD as described above, low intensity FUS can be used in an entirely different way to help treat PD. This type of FUS may allow for disruption of the blood brain barrier. The blood brain barrier refers to the cells that line the blood vessels within the brain which keep foreign substances, such as toxins and microbes, in the bloodstream and out of the brain.
Normally, this mechanism is advantageous and protects the brain. However, the blood brain barrier may also keep out molecules that could help to treat brain diseases. Therefore, disrupting the blood brain barrier could allow for penetration of these molecules into particular areas of the brain. A whole variety of different molecules such as antibodies, nerve growth factors and gene therapy may be able to take advantage of this approach. Further research is necessary to determine if this will be a useful method for drug delivery into the brain.
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Focused Ultrasound Has Potential As A Non
Most people with Parkinsons will use medication to help control their symptoms, but for some, over time, medications alone may no longer be enough to control symptoms. This is when specialists may look towards surgical options. Currently deep brain stimulation offers the main surgical way to control movement symptoms of Parkinsons.
This type of surgery involves inserting fine wires into the brain to be controlled by a pulse generator that is placed under the skin around the chest or stomach area. When the pulse generator is switched on, the electrodes deliver high frequency stimulation to the targeted area. This stimulation changes the electrical signals in the brain that are causing some of the movement symptoms of Parkinsons.
But what if there was another way to target cells deep within the brain? This is where a technique called focused ultrasound comes in. It offers a way to change the way the brain works without the need for invasive brain surgery.
In this blog we find out exactly what focused ultrasound is and how it might help people with Parkinsons in the future.
To learn more, we spoke to Professor Wladyslaw Gedroyc, Consultant Radiologist at Imperial College Hospital, who has over 20 years experience investigating the potential of focused ultrasound.
Thank You One Last Question: If You Had To Share One Quote About Mrgfus What Would It Be
Our ability to help people get better, live the lives they want to for longer, and in the way and fashion they want to is only getting better through science and technology. Focused ultrasound is a great example of that. Reaching out and challenging the opportunities for yourself and your loved ones is important. Ask about these therapies and make sure your neurologists, neurosurgeons, and caregivers understand what the best opportunities are for you. Think of focused ultrasound as one element of the journey to wellness certainly, one that we are very happy to bring to Parkinsons patients and their families.
Treatment plans are collaborative. It is clear that Desai is an advocate for patients understanding available treatment options as they continue to emerge. With education, we can advocate for ourselves and be part of the plan.
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The Power Of Focused Ultrasound
It was a decade ago that Elias treated his first clinical trial volunteer with essential tremor, a common movement disorder, using the focused ultrasound technology. Since then, Elias and his neurology collaborator Binit Shah, MD, have been leaders in developing MRI-guided focused ultrasound as a commercially approved procedure. UVAs work, for example, paved the way for the federal Food and Drug Administration to approve the technology to treat essential tremor in 2018, and the agency has now expanded that approval to include other common Parkinsons symptoms, including rigidity and involuntary movements, for appropriate patients.
Neal F. Kassell, MD, chairman of the Focused Ultrasound Foundation, hailed the FDAs decision. The Foundation has long considered the brain to be a vanguard target for focused ultrasound, and this ruling by the FDA is a huge win for both providers and patients, said Kassell, a former UVA neurosurgeon.
Elias, too, is excited about what the approval could mean for Parkinsons patients. This ultrasound technology is obviously very popular with patients because it can be performed on an outpatient basis and without any incision, he said. It is still very early stage for a new procedure, so experience and technological advances will increase the safety and effectiveness.
Regulatory Approval & Reimbursement
The Exablate system manufactured by Insightec is approved in Europe and in the US for treating tremor-dominant Parkinsons disease. Patients should talk with their physician if they are not sure if they have tremor-dominated Parkinsons disease. We recommend that they talk with the treatment site for questions about insurance coverage under Medicare, as some treatment sites are now being reimbursed by Medicare. Most commercial companies are not currently covering this procedure.
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Patient: Focused Ultrasound Changed My Life
Parkinson’s disease not only progressively robs people of their mobility it often erodes their social networks built over years of shared interests and experiences. Symptoms such as involuntary headshaking and jerking of the limbs can make many people who have the disease feel acutely self-conscious, to the point they withdraw from most social activity.
One man who managed to stave off this devastating outcome was an early participant in clinical trials for focused ultrasound led by UMSOM researchers at UMMC. For this patient, relief came within minutes after the procedure began–which ultimately eliminated 95% of the involuntary movements caused by his medication and reduced his tremors by half. Over seven years later, these outcomes have lasted, although his disease has advanced on other fronts.
“The focused ultrasound I received at the University of Maryland Medical Center changed my life by giving me back the ability to do the things I love. I’m in a competitive bowling league. I play golf. I ride my bike,” said Steve Squires, 46, of Middlebury, Indiana, who had the procedure in 2015 as part of the pilot study.
Squires noted that while focused ultrasound isn’t a cure for Parkinson’s, it helped him return to many of his normal activities. “It also gave me a platform to share with others who have Parkinson’s that there are new treatment optionsyou don’t have to suffer this alone,” he said.
Focused Ultrasound For Parkinsons Disease
Although elective procedures are currently being postponed in hospitals across the country because of the necessary focus on COVID-19, eventually our hospitals will return to normal and non-emergent procedures will be performed again. This will include elective procedures for the treatment of Parkinsons disease .
Two brain procedures that are approved for use in PD are deep brain stimulation and high intensity focused ultrasound . I encourage you to read more about DBS and view our webinar which outlines the newest features of this procedure.
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Rapid Reversal Of Symptoms
Focused ultrasound is a completely incisionless procedure, performed without the need for anesthesia or an in-patient stay in the hospital. Patients, who are fully alert, lie in a magnetic resonance imaging scanner, wearing a specialized energy conversion helmet for the procedure. Ultrasonic energy is targeted through the skull to the globus pallidus, a structure deep in the brain that helps regulate voluntary movement. MRI images provide doctors with a real-time temperature map of the area under treatment.
Often before the procedure is even completed, patients experience relief from severe symptoms such as tremors, rigidity in the legs and arms, and side effects from medications that cause involuntary, erratic movements called “dyskinesia.”
About one million Americans have Parkinson’s disease, a neurodegenerative disorder that affects brain cells or neurons in a specific area of the brain that produce the brain chemical dopamine. Other current treatments for Parkinson’s include medications and deep brain stimulation from surgically implanted electrodes.
Government Assistance For Parkinsons Patients
PANFs Parkinsons disease fund assists eligible individuals and families in covering the cost of critical medications with out-of-pocket expenses. As a result, the annual maximum amount available to them is $16,500.
Non-medical Parkinsons care costs an average of $10,000 per year for families. It is estimated that this amount is paid out of pocket or not covered by insurance. Non-medical care, on the other hand, assists you in maintaining your daily activities. This article describes which insurance programs are most commonly used, as well as what other types of financial assistance are available. Parkinsons patients ability to bathe or take care of their oral hygiene is compromised. Food preparation is nearly impossible, feeding oneself is difficult, and assistance is usually required. Because of the sleep challenges that patients with Parkinsons disease face, 24-hour observation is critical to their well-being.
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Fda Approves Focused Ultrasound For Parkinsons Symptoms
Jeff Elias, MD, pioneered the use of focused ultrasound for the treatment of essential tremor and Parkinsons disease.
The federal Food and Drug Administration has approved an incisionless form of brain surgery to treat advanced Parkinsons disease after successful testing at the School of Medicine and other sites.
The authorization allows the use of Insightecs Exablate Neuro focused ultrasound device to treat problems with mobility, rigidity and involuntary movements known as dyskinesias that are common in Parkinsons. UVA is one of only 37 medical centers in the country with the capacity to offer this minimally invasive treatment, according to the Charlottesville-based Focused Ultrasound Foundation, a longtime supporter of UVAs pioneering research into the many potential applications of the technology.
Prior to the approval, available treatments for the Parkinsons symptoms included drugs, which not all patients respond to, and invasive deep-brain surgeries. Focused ultrasound, in comparison, does not require incisions or cutting into the skull. Instead, the technology focuses sound waves inside the brain to interrupt faulty brain circuits, much like a magnifying glass can focus light to create heat. During the focused ultrasound procedure, doctors use magnetic-resonance imaging to peer inside the brain in real-time before making any permanent changes, helping ensure patients get the best possible outcomes.
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A New Era For Parkinsons Disease Treatment
A diagnosis of Parkinsons disease no longer automatically portends a future of extremely limited physical capabilities. Thanks to the commitment of researchers like Dr. Eisenberg and Dr. Fishmanand clinical trial participants like Steve Squirestreatment has expanded to include non-invasive options that significantly reduce certain symptoms within minutes and transform the lives of people who had been living with debilitating symptoms, said Bert W. OMalley, MD, President and CEO of the University of Maryland Medical Center.
Our school of medicine researchers have established themselves as world leaders in pioneering MRI-guided focused ultrasound for many devastating brain diseases, including Parkinsons and essential tremors, said E. Albert Reece, MD, PhD, MBA, Executive Vice President for Medical Affairs, UM Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine. The stellar work of Dr. Eisenberg and Dr. Fishman has led to a new era in which this breakthrough modality has now become the standard of care for patients looking for less invasive treatments for their symptoms.
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Ld: Thank You For Allowing Our Mutual Friend To Introduce Us And For Agreeing To Answer Some Questions Most Patients Are Familiar With Deep Brain Stimulation As A Parkinsons Treatment But What Is Mrgfus
AD: MRgFUS is an incision-less therapeutic treatment, which uses MRI-guided ultrasound waves to precisely target and treat areas deep inside the brain that cause movement problems.
It sounds straightforward. However, the brain presents challenges due to the skull scattering the sound waves. By using advanced ultrasound technology in combination with real-time MRI images, we are able to refocus the energy beyond the skull and into the brain. During the treatment, we use the MRI along with an alert patient to test brain areas for accuracy by delivering a test dose, which if correct will temporarily fix the disorder. With this clinical confirmation, the full therapeutic dose is delivered, where the energy precisely creates heat to form a permanent lesion at the targeted brain area.
The treatment is irreversible and currently offered as a unilateral treatment, meaning only one side of the brain is treated. However, there is ongoing research to assess whether a bilateral approach demonstrates appropriate safety and efficacy. This would be a staged process and based on a case-by-case basis of patient symptoms.
What Are The Risks And Limitations Of Focused Ultrasound
Focused ultrasound for tremor has minimal side effects. Some patients experience temporary side effects during and after treatment. It is rare for these symptoms to last more than a week.
The most common side effects are:
- Skin irritation on the scalp
- Imbalance or trouble walking
This treatment is effective for most patients, but there are limits.
- We can only perform the treatment on one side of your body. Your non-dominant side will still have tremor symptoms. Research is underway to learn if we can use focused ultrasound for both sides in the future.
- The treatment can vastly improve your tremor, but wont stop it completely.
- This is not a cure. Essential tremor and Parkinsons disease get worse over time and this treatment cant stop the progression. You and your doctor can discuss if retreatment with focused ultrasound is best for you, or you can try another option like deep brain stimulation.
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