Patient's tremors disappear after incision-free brain surgery

On a recent morning, Forrest Ault walked into AdventHealth Celebration with tremors in both arms so severe that he struggled with simple tasks such as drinking from a cup, writing or clearing the dinner table.

Just hours later, he drove back to his Central Florida home with his left arm restored to how it once was - the uncontrollable shake was gone.

“I was a one-armed man and now I have two arms again,” said Ault as he reflected back on those first moments after he became one of the first patients to undergo an incision-free brain surgery called Focused Ultrasound recently launched at AdventHealth.

Ault, who began experiencing tremors as early as his teens, had developed rhythmic shaking in both arms, but his left side – the one that was treated – was far worse. For years, doctors told him there wasn’t much that could be done to help.

“When I saw him and he held out his hand, I just broke out crying,” she said.

That changed when he learned about the procedure technology by Insightec and talked with Chandan Reddy, MD, a neurosurgeon at AdventHealth who performs the procedure.

“Talking with Dr. Reddy made me feel better than anything,” Ault said. “He was great.”

He said he was skeptical when he learned the results would happen so quickly and be so transformative.

“In your mind, you’re going, ‘Yeah, sure OK,’ and I was hoping for a 70% reduction or something like that,” he said. “But it was instantly no tremor at all.”

Ault’s wife, Anne, said she was stunned by the outcome.

“When I saw him and he held out his hand, I just broke out crying,” she said. “The joy of seeing what that surgery did and accomplished … there aren’t any words.”

Dr. Reddy said he knew when he met Ault that the procedure could be a “life-changing event” for him as it is with many patients who suffer from essential tremor, which often interferes with everyday tasks and can cause discomfort or embarrassment in social situations.

During the procedure, the patient undergoes an MRI while wearing a helmet with transducers that can focus more than a thousand beams to heat the exact point in the brain that is causing the tremors.

“The MRI allows us to target and also measure the temperature in the brain,” Dr. Reddy said. “This technology allows us to very precisely target and destroy a tiny area in the brain that’s part of the tremor circuit.”

While the Focused Ultrasound treatment is incision-free, patients must have their heads shaved and have a frame attached to their head to keep them motionless during the treatment.

The traditional alternative surgery to treat essential tremor typically requires an overnight hospital stay and weeks of recovery time because the skull must be opened to access the portion of the brain causing the tremor.

The minimally invasive nature of the Focused Ultrasound procedure played a big role in convincing Ault to move forward. His procedure was at 11 am and he and his wife were on their way home by mid-afternoon, he said.

AdventHealth Celebration, which launched the innovative treatment earlier this year, has performed more procedures than any other location in Central Florida with patients traveling from as far as Alaska.

The offering is the latest in AdventHealth’s suite of minimally invasive brain surgery techniques along with GammaKnife, LITT (Laser Interstitial Thermal Therapy), Endoscopic endonasal skull-base surgery, endoscopic microvascular decompression and port-based surgeries.

AdventHealth, which is one of the Top 50 neurology and neurosurgery programs in the country, according to US News & World Report, has built its minimally invasive brain surgery program over 20 years to treat a variety of brain tumors and other disorders. Those techniques have provided excellent outcomes to a growing number of patients who seek out care at AdventHealth, said Mel Field, MD, neurosurgeon and medical director for AdventHealth’s Minimally Invasive Brain Surgery Program.

“These procedures offer a gentler approach than traditional surgeries for certain tumors or disease that already have established treatments – and the outcomes are typically equal or better than those standard treatments,” Dr. Field said. “Minimally invasive brain surgery also offers people who have no other options, a way to treat deep or complicated brain disease.”

For Ault, the Focused Ultrasound procedure allowed him to return to things he loves such as cooking and painting and even perform simple chores like clearing the table after dinner and a “bunch of little things that no longer complicate your day.”

“If you qualify, you should go for it,” Ault said.