MR-guided Focused Ultrasound (MRgFUS) in Hyderabad
— First in Telangana/AP · Non-Invasive Neurosurgery at KIMS

MRgFUS (MR-guided Focused Ultrasound) is a non-invasive brain treatment that requires no incision, no general anaesthesia, no implanted device, and no radiation. It uses 1,024 focused ultrasound beams that converge through the intact skull to a precise target in the brain — the Vim nucleus of the thalamus — creating a small focal lesion that interrupts the tremor circuit. Conventional brain surgery (such as deep brain stimulation, or DBS, which requires drilling holes in the skull and implanting electrodes) involves open surgery, general anaesthesia, and an implanted device that requires battery replacement every 5–9 years. MRgFUS achieves the same therapeutic target — a thalamotomy — without any of these elements. The patient is awake throughout, receives no anaesthesia, and goes home the same day. The treatment is completed in approximately 1.5–2 hours. KIMS performed the first MRgFUS procedure in Telangana and Andhra Pradesh. Call 040-44885000.

Yes — MRgFUS is specifically indicated for patients with essential tremor (ET) who have not had adequate response to medication. The FDA approval for essential tremor (2016) is based on a New England Journal of Medicine randomised controlled trial that demonstrated 75% tremor reduction at 12 months — in patients who had already failed medical management. The eligibility assessment at KIMS for MRgFUS includes: confirming the diagnosis of essential tremor · documenting failed medical treatment (which you have) · brain MRI to assess skull anatomy · measurement of the skull density ratio (SDR, a measure of how well ultrasound transmits through your skull — requires a head CT) · general medical assessment. The most important eligibility factor that cannot be determined from clinical information alone is the skull density ratio: approximately 20–30% of patients have skull bone that does not transmit ultrasound adequately (SDR below 0.4) and are not eligible for MRgFUS. The remainder are generally eligible. Call 040-44885000 to schedule an MRgFUS eligibility assessment at KIMS.

Yes — MRgFUS received FDA approval for Parkinson's disease tremor (the tremor that is dominant at rest and often described as a pill-rolling movement) in 2018, based on a New England Journal of Medicine randomised controlled trial that demonstrated significant improvement in tremor scores versus sham treatment. Important distinction: MRgFUS for Parkinson's disease treats the tremor component of Parkinson's specifically — it does not treat bradykinesia (slowness), rigidity, or the other motor features of PD. If tremor is the dominant and most disabling feature, MRgFUS is an excellent option. If bradykinesia and rigidity are equally or more disabling, DBS (which can address multiple PD motor features simultaneously) may be a better choice. The same skull density ratio eligibility criterion applies for PD tremor as for essential tremor. At KIMS, the movement disorders team assesses whether your father's clinical profile makes MRgFUS or DBS the more appropriate intervention. Call 040-44885000.

Both MRgFUS and DBS can effectively treat essential tremor and Parkinson's disease tremor by targeting the Vim nucleus of the thalamus. They differ in several important ways: MRgFUS: no surgery, no implant, no anaesthesia, completed in one day, no battery to replace, irreversible (the lesion is permanent), unilateral only (treats one hand at a time). DBS: open surgery, implanted electrodes and pulse generator, general anaesthesia, requires battery replacement every 5–9 years, reversible and adjustable (stimulation parameters can be changed), can be bilateral (treats both hands). The choice depends on: bilateral tremor (DBS can treat both sides; MRgFUS cannot) · Skull density ratio (if SDR is too low, DBS is the only option) · Preference for adjustability (DBS can be reprogrammed; MRgFUS cannot) · Preference for avoiding surgery and implants (MRgFUS) · Medical fitness for surgery (MRgFUS is appropriate even for patients not fit for general anaesthesia) · Age (older patients often prefer MRgFUS for its simpler recovery). At KIMS, the movement disorders team discusses both options at the initial consultation and provides a personalised recommendation. Call 040-44885000.