He had first considered deep brain stimulation (DBS), a more common neurosurgical treatment that has proven effective in treating his disorder. Unfortunately, medications did not work for Williams, and his tremor became worse. Patients find it a challenge to eat, drink, write, or perform other daily functions, and often avoid social outings. Essential tremor can affect the hands, feet, face, and voice. He had seen a movement disorder neurologist, who prescribed medications. Over the years, Williams had learned to make do with his left hand. Eating, drinking, and writing all became difficult tasks, especially since he is right-handed. “I couldn’t place a golf ball on a tee,” he revealed. The chief executive officer of a local door manufacturing company in Maryland, Williams had heard about magnetic resonance imaging-guided focused ultrasound for tremor a few years ago. The patient, 76-year-old John Williams, had been experiencing tremor of his right hand for the past several years. “Neurosurgeons prefer bald patients,” I replied from our pre-operative wing, where preparation for focused ultrasound treatment includes a shaved head. Bald is beautiful, and it’s better than a rug or a combover,” he said.
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