SEATTLE, Aug. 27, 2012 – Since its opening in 2008, the Ben & Catherine Ivy Center for Advanced Brain Tumor Treatment (the Ivy Center) at Swedish Medical Center's Neuroscience Institute has led the expansion drive of major research projects and expanded treatment options for patients living with brain cancer in the Pacific Northwest and throughout the world. The Ivy Center was founded in 2008 to create a world-class treatment and research facility focused on delivering excellent patient care and advancing progress toward more effective treatments for brain cancer.
Do you or someone you know shake when raising a glass of water to drink or have problems writing a check at the grocery store?
If so, essential tremor may be the cause. Essential Tremor (ET) is the most common movement disorder and those suffering from it experience uncontrolled movement , usually of the hands and arms. Over 10 million Americans are diagnosed, yet many people have never heard of it. Some assume shaking is just a sign of aging or they fear they may have Parkinson’s disease. ET differs from Parkinson's in many ways, one being ET is an "action" tremor (more pronounced when trying to complete a task) where a person with Parkinson's has tremors more often at rest and the shaking may actually lessen during activity.
Essential Tremor is caused by overactive cells in the area of the brain called the thalamus. The thalamus is about the size of a walnut and within the brain there are two of them. If there are overactive cells in the right thalamus, the person will have signs of tremor on the left side and vice versa. Some patients suffer from tremor on both sides.
It is important to know Essential Tremor is a treatable condition.
There are three common methods of treatment:
If you have never heard the term radiosurgery, you are in good company. This sci-fi sounding word may conjure images from Star Trek but radiosurgery is anything but fiction.
Radiosurgery uses multiple beams of radiation from a variety of directions to destroy diseased or damaged tissue. Although the name sounds like a surgical procedure, this is a non-invasive way to treat many different conditions. The CyberKnife and Gamma Knife technologies are very precise and avoid injury to surrounding, normal tissue and the course of treatment lasts from a single session to less than 2 weeks...
There was cause for celebration in the Swedish Radiosurgery Center on Thursday, Dec. 16, as neurosurgeon Ronald Young, M.D. (left), medical director of the Gamma Knife® program, and radiation oncologist Bob Meier, M.D. (below), medical director of the CyberKnife program, treated the center’s first two Gamma Knifepatients. The center, formerly known as the Seattle CyberKnife Center, supports both the Swedish Cancer Institute and the Swedish Neuroscience Institute.
The center has offered CyberKnife services since 2006. This year Swedish installed an Elekta Leksell Perfexion Gamma Knife®, making it one of the most advanced stereotactic radiosurgery centers in the country. CyberKnife can be used to treat cancerous and noncancerous tumors in all areas of the body.
At Swedish, Gamma Knife will be used to treat cancer of the brain and some neurological conditions, such as essential tremor, trigeminal neuralgia and arteriovenous malformations. Providing Swedish neurosurgeons and radiation oncologists access to both of these advanced technologies gives them greater flexibility in selecting the best radiation therapy for their patients. For more information, go to www.swedish.org/radiosurgery or call 206-320-7130.
Essential tremor (ET) is the most common type of movement disorder, affecting approximately four out of 1000 people, and is significantly more common, though less recognized, than Parkinson’s disease. ET affects men and women equally and is inherited as an autosomal-dominant condition in about 60 percent of cases.
Although often referred to as benign essential tremor, it is hardly benign in patients who may not be able to write legibly, hold a glass of water or use a knife and fork. ET is primarily an action tremor of the upper extremities but may involve resting tremor of the head and neck and/or lower jaw, and also tremor of the voice. The latter may be so severe that speech becomes unintelligible.
Medication and surgical treatment options
Primidone and beta blockers are useful in reducing tremor in the early stages of ET, but as the tremor progresses, medical management often becomes less effective or side effects can prevent the use of adequate doses of medication. ET patients then are candidates for surgical or radiosurgical treatment.
The mainstay of the surgical treatment of ET is deep brain stimulation (DBS), in which an electrode is implanted in the ventral intermediate nucleus (VIM) of the thalamus. Neurosurgeons Peter Nora, M.D., and Ryder Gwinn, M.D., have been implanting DBS electrodes at Swedish Medical Center for several years. The treatment is effective, but it requires implantation of permanent hardware (wires and batteries) into the brain and chest wall. Patients who take anticoagulants or have severe cardiovascular disease are not suitable candidates for DBS. These patients, however, may be candidates for radiosurgical treatment.
A new option for difficult-to-treat patients