Undergoing MR-guided focused ultrasound (MRgFUS) thalamotomy for essential tremor or tremor-dominant Parkinson’s Disease is a significant step towards improving functional mobility and your quality of life. While the procedure itself is incisionless and relatively convenient compared to other surgical treatments, understanding the recovery process can help ease any anxieties and set realistic expectations. We have written this article to help you understand what you can expect after your treatment.

Immediately After the Procedure

The MRgFUS procedure typically takes around 3 hours.  As soon as the procedure is complete, you will be brought out of the MRI scanner and to a recovery area, where the treatment team will remove the frame that will have been placed on your head at the start of the procedure.  The screws used to hold the frame in place will leave four small cuts on your scalp, which will just require some small simple dressings.  No stitches will be needed.

Once you have changed back into your own clothes, we will then ask you to wait with us for around 30-60 minutes before you leave.  We will provide you with something to eat and drink, and our neurologist will provide you with some medications to take away with you.

It is common to feel tired immediately after the procedure.  Even though you don’t do a lot during the procedure, the noise of the MRI scanner and the activity going on around you can be tiring.  Some patients might also experience mild headaches or nausea after the procedure, but these symptoms typically resolve within a few hours and can be easily managed with the medications that we will provide you with.

Once you have had something to eat, have received your medications, and are feeling happy to leave, you will then be free to leave.  We require patients to stay in a local hotel for one night following the procedure, so that we can see you again for a check up the following day before you head home.  Over the course of the rest of the day, you can expect to gradually feel back to your normal self and to eat and drink as normal after the procedure.  In the words of one of our earlier patients:

“On the evening of my treatment, I celebrated by eating a Japanese meal with chopsticks, which I had not done for over six years!”

The First Few Days

We would always recommend that you plan to rest at home for the first couple of days after treatment, avoiding strenuous activities to give you time to rest and recover from the busy activity of the treatment day. It’s important to stay hydrated, eat light, nutritious meals and to stay mobile with some short walks.

Many patients notice a significant reduction in tremor immediately after the procedure, which can be an extremely rewarding experience. However, it’s also normal for some patients to experience a more gradual improvement that may happen over a few weeks.

While there are no scheduled follow up appointments until 3 months after treatment, our treatment coordinators are always on hand should you have any concerns or need to ask any questions.

The First Few Weeks

For some patients, improvement in their tremor may have been immediate. For others, tremor control may continue to develop for several months. We will remain in contact with you so we can monitor your progress and make suggestions for altering your medications if necessary.

You will be able to resume normal activities as you feel able but listen to your body and don’t rush the process. Light activities like walking are usually encouraged but avoid heavy lifting or intense exercise until the neurologist gives you the go-ahead.

Whilst rare, we do recognise the potential for some side effects after treatment.  Some patients might find they have a slight numbness or tingling in the treated hand or around the mouth.  Some may also experience difficulty with balance.  For this reason, we strongly recommend that you have a walking aid to use, and that you continue to use this for the first few weeks to months after treatment to avoid any falls. 

These side effects should not be significant enough to interfere with your day-to-day activities and are usually temporary.  We normally expect these to have fully resolved by the time the patient comes for their 6 month follow up visit.

By this time,you will have been scheduled for a series of follow-up appointments to check your progress. We normally invite patients for a telephone consultation at 3 months, and an in-person consultation at 6 months and 1 year post treatment.  During these visits, our neurologist will assess the effectiveness of the treatment and check for any side effects.  At the 6-month visit, we also repeat the MRI scan.  It is important that you attend these follow-up appointments and report any concerns.

Long-Term Recovery

As your tremor improves, it our aim that you will be able to return to activities you may have previously been unable to do, or even avoided. This can be a wonderful time to re-engage with hobbies and tasks that bring you joy and satisfaction.  One earlier patient was successful in winning a Golf competition at his local club just 3 months after his treatment.

Outcome data from our treatments performed so far has shown that by the 6-month follow up, half of patients experience only mild persistent side effects which do not hinder daily function.  The wider literature suggests that many of these side effects should ultimately resolve by the 12- month mark.

Tips for a Smooth Recovery

1. Follow Medical Advice: Our treatment team will offer you post-procedure guidance, including some prescribed medications which you will need to take for 1-2 weeks.  This guidance and the medication we provide are intended to support your recovery, improve the outcome of treatment and reduce the risk of any side effects.  It is therefore particularly important to stick to the guidance as best you can.
2. Take It Easy: You should give yourself permission to rest and recover. Despite the treatment not requiring any incisions, general anaesthetic or hospital admissions, it is important to recognise that it is still a form of surgery, which has both a physical and emotional effect on our bodies. Overdoing it too soon can slow down your recovery.
3. Stay Hydrated and Nourished: Eating well and staying hydrated will support your recovery.
4. Stay in touch: If you have any concerns or questions during your recovery, don’t hesitate to contact us. Our treatment coordinators are here to support you through every part of your journey, from first enquiry through to your post-treatment care.

Conclusion

Recovering from MR-guided focused ultrasound thalamotomy is a process that varies from person to person. By understanding what to expect and following the advice given by our treatment team, you can maximise the benefits of the procedure and enjoy a smoother, more effective recovery. Celebrate the small victories along the way and look forward to the positive changes this treatment can bring to your life.

For more information about the MRgFUS service in Queen Square or to make an enquiry, please contact the service at treatment@queensquare.com or 020 7833 2513.