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EMERGENCY:For new or worsening neurological deficit after MRgFUS, severe headache unresponsive to paracetamol, or persistent unsteadiness — call the KIMS emergency line —call040-46324365immediately — 24 hours, 7 days— 24/7

MRgFUS · PATIENT JOURNEY

MRgFUS Patient Journey — From First Call to Going Home Tremor-Free at KIMS Hyderabad

Q: My head will be shaved for the MRgFUS procedure. How quickly will my hair grow back?

The entire scalp is shaved before the Exablate Neuro helmet is fitted — this is required for acoustic coupling between the ultrasound transducers and the scalp. The shaving is done by the KIMS nursing team on the morning of the procedure and takes approximately 30 minutes. Hair regrowth: scalp hair grows at approximately 1–1.5 cm per month. By 3 months after the procedure, most patients have 3–4 cm of hair; full hair length (if the hair was previously long) typically returns within 6‒9 months. In the weeks immediately after the procedure, the shaved scalp is usually covered with a hat, headscarf, or turban as preferred. Many female patients who have planned ahead choose a short haircut in the weeks before treatment to make the regrowth period more manageable. The KIMS team can discuss practical approaches based on individual preference. Call 040-44885000.

Q: I am very afraid of enclosed spaces. Can I cope with being inside the MRI scanner for 1.5–2 hours?

Claustrophobia is a common concern for patients undergoing MRgFUS, and the KIMS team addresses it proactively. Practical mitigations: (1) The open end of the MRI bore faces the patient, and the team is visible and audible through the intercom throughout the procedure. (2) Music, podcasts, or audiobooks can be played through MRI-compatible headphones during the scanning and treatment phases. (3) An anxiolytic medication (oral diazepam 5–10 mg or lorazepam 1–2 mg) can be given before the procedure. (4) The patient can request a pause and temporary withdrawal from the MRI bore at any point during the procedure — the Exablate Neuro system accommodates brief pauses without compromising the treatment. (5) The team members maintain continuous verbal communication throughout, providing frequent updates on progress. For most patients with mild to moderate claustrophobia, these measures are sufficient. For patients with severe, phobia-level claustrophobia (inability to tolerate MRI even with sedation), MRgFUS may not be feasible, and DBS should be considered. A test MRI visit before the treatment day can help clarify tolerability for anxious patients. Call 040-44885000.

Q: My tremor is in the left hand (I am right-handed). Which side of the brain will be treated?

The MRgFUS thalamotomy targets the thalamus on the side opposite to the tremoring hand. For a right-handed patient whose right hand trembles, the left Vim thalamus is targeted. For a left-hand tremor, the right Vim thalamus is targeted. If your most functionally disabling tremor is in the left hand (even though you are right-handed), the treatment targets the right thalamus for the left hand tremor. In patients with tremor in both hands where one hand is significantly more affected than the other, treatment of the more affected side is recommended first. If the result is satisfactory, the decision about whether to treat the other side (with DBS, since bilateral MRgFUS is not recommended) can be made at a later stage. The movement disorders team at KIMS will advise on the optimal treatment strategy for bilateral tremor at your eligibility assessment. Call 040-44885000.

Q: After MRgFUS, will I be able to return to normal activities immediately?

Most patients return to normal light activities within 1–3 days of treatment. Specific activities: (1) Eating and drinking: improved immediately after treatment — most patients have a meal on the treatment day using utensils that may have been difficult for years. (2) Writing and fine motor activities: improved immediately, continuing to improve over the first 1–2 weeks as post-procedure oedema resolves. (3) Driving: not on the day of treatment (pre-procedure medication) · resume after 1 week or when cleared by the KIMS team · if significant unsteadiness is present, driving is delayed. (4) Work (desk/office): most patients return within 3–5 days. (5) Physical work or exercise: gentle activity from day 3–7; more strenuous activities after 2 weeks. (6) Alcohol: avoid for 2 weeks (worsens tremor and can mask improvement assessment). The improvement seen immediately after treatment is usually the minimum — the lesion continues to mature over the first 1–3 months, and some patients see additional improvement during this period. Call 040-44885000.

From the first phone call through eligibility assessment, treatment day, recovery, and follow-up — the complete MRgFUS patient journey at KIMS Neuroscience, in the order it unfolds, from the patient's perspective.

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The Complete Journey — In the Order It Unfolds

For a patient with essential tremor who has spent years managing an increasingly debilitating condition, understanding exactly what the MRgFUS process involves — from the first phone call to the follow-up after treatment — is essential for making an informed decision. This page describes the complete MRgFUS journey at KIMS in the order it unfolds, from the patient's perspective.

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Same-day eligibility assessment; 2-day combined itinerary available for patients travelling from AP and Telangana.

040-44885000Email: neuroscience@kimshospitals.com

★ Definition — MRgFUS at KIMS, The Journey in Brief

One Eligibility Visit · One Treatment Day · Three Follow-Ups

The MRgFUS journey at KIMS typically involves: one eligibility assessment visit (half a day) · one treatment day (1.5–2 hours procedure, same-day discharge for most patients) · follow-up at 1 month, 3 months, and 12 months (can be done remotely for out-of-Hyderabad patients). The tremor typically improves during the treatment itself — most patients notice the improvement while still on the treatment table.

Phase 1: The first contact — what to say and send: Call 040-44885000 or email neuroscience@kimshospitals.com with: tremor diagnosis, duration, medications tried and their results, and any prior MRI scans. The KIMS MRgFUS team reviews the information and advises whether an in-person assessment is appropriate — a preliminary filter that saves unnecessary visits. Out-of-Hyderabad patients (AP, Telangana, Karnataka, Odisha) can pre-screen by phone and arrange the combined 2-day eligibility + treatment itinerary.
Phase 2: The eligibility assessment — one day, same-day result: Step 1: Clinical consultation (60–90 min) — tremor history, TETRAS or MDS-UPDRS assessment, spiral drawing, writing sample, video of baseline tremor. Step 2: 3T brain MRI (30–45 min) — excludes structural causes, identifies Vim thalamus coordinates. Step 3: Thin-slice head CT — for SDR calculation. Step 4: Same-day eligibility decision and consent consultation — the patient leaves knowing. If SDR < 0.4, told same day, no further visits wasted.
Phase 3: Preparing for treatment day — the checklist: The night before: wash hair with shampoo, no conditioner, no hair products of any kind (oils, gels, sprays). Fast from midnight (no food or drink except medications). Bring: a companion (required for the day), all prior MRI films and CT scans, the current medication list, and a music playlist or podcasts (the planning phase of 30–45 minutes inside the MRI is non-painful but long). The KIMS team sends a detailed written checklist to every patient after the eligibility visit.
Phase 4: Treatment day — what happens, hour by hour: Approximate 7:30am arrival. Scalp shave (for transducer-array contact). Stereotactic frame attachment under local anaesthetic (the most uncomfortable part of the day for most patients). Pre-treatment MRI. Planning phase (30–45 min): sub-therapeutic sonications at 45–48°C to confirm target — patient reports sensations, physician adjusts. Therapeutic sonications (~15–20 min of active treatment) at 55–60°C for 10–15 seconds each. Post-treatment MRI. Frame removal. Neurology check. Most patients leave by 2:30pm with tremor substantially reduced.
Phase 5: Recovery and follow-up — remote options: Same-day discharge for most patients. The treated hand may be weak for a few hours; light activity can be resumed in 1–3 days; balance-dependent activities (swimming, cycling) should wait 2–4 weeks. Follow-up: 1-month video clinic (remote from any location), 3-month review (clinical assessment + MRI, can be done at a local MRI centre with images sent to KIMS), and 12-month in-person reassessment at KIMS. The team is accessible by email for any post-procedure concern.

The Five Phases at a Glance

The MRgFUS Journey Stack at KIMS

Five phases — from the first phone call to long-term follow-up — each described in clinical detail in the sections below.

Phone · Email · Pre-Assessment

Phase 1: The First Contact

Call 040-44885000 or email neuroscience@kimshospitals.com with your tremor history, medication trials, and any prior MRIs. The KIMS MRgFUS team advises whether an in-person assessment is appropriate.

Single Day · Same-Day Result

Phase 2: The Eligibility Assessment

Clinical consultation (60–90 min) + thin-slice head CT for SDR calculation + 3T brain MRI + same-day eligibility decision and consent consultation. All four steps in one visit.

Day-Before Checklist

Phase 3: Preparing for Treatment Day

Wash hair · no hair products · fast from midnight · bring a companion, MRI films, medication list, and music/podcasts for the planning phase.

7:30 am – 2:30 pm · Same-Day Discharge

Phase 4: Treatment Day

Arrival · scalp shave · frame · pre-MRI · planning · sub-therapeutic then therapeutic sonications · post-treatment MRI · frame removal · discharge. Most patients leave with a hand that no longer shakes.

1 mo · 3 mo · 12 mo

Phase 5: Recovery and Follow-Up

Same-day discharge for most patients · normal light activity in 1–3 days · 1-month video clinic · 3-month MRI (can be local) · 12-month in-person reassessment.

Phase 1

The First Contact

Initial enquiry and pre-assessment

Call 040-44885000 or email neuroscience@kimshospitals.com with your clinical details: your tremor diagnosis · how long you have had the tremor · which medications you have tried and their results · any relevant MRI scans already performed. The KIMS MRgFUS team reviews the information and advises whether an in-person eligibility assessment is appropriate. Patients from outside Hyderabad (AP, Telangana, Karnataka, Odisha) are welcome to contact KIMS directly — the eligibility visit and treatment can be combined into two visits on consecutive days to minimise travel.

Phase 2

The Eligibility Assessment Visit

The eligibility visit proceeds in four sequential steps — completed in a single day with a same-day result and same-day consent consultation.

Clinical consultation with the movement disorders specialist

Duration: 60–90 minutes. The neurologist or movement disorders specialist reviews your tremor history, performs a standardised tremor assessment using the TETRAS scale (for ET) or MDS-UPDRS (for PD), and obtains a detailed medical history. You will be asked to: write a sentence and draw a spiral (the Archimedes spiral — a standard tremor severity measure) · pour water between cups · touch your finger to your nose · perform standard coordination tests. A short video of your tremor is taken to document baseline severity for comparison after treatment.

Brain MRI — anatomy and target planning

If a recent high-quality 3 Tesla MRI of the brain is not available, it is performed on the same day. The MRI serves two purposes: (1) Excludes structural causes of tremor (tumour, stroke, multiple sclerosis plaques) that might affect treatment safety. (2) Provides the anatomical images from which the Vim thalamus target is identified and its coordinates determined. The MRI takes 30–45 minutes.

Head CT for skull density ratio calculation

A low-dose thin-slice CT of the head (without contrast, takes 5–10 minutes) is performed. The CT data is analysed using the Insightec SDR algorithm to calculate your skull density ratio. The result is available within 1–2 hours. SDR ≥0.4 = eligible for MRgFUS · SDR <0.4 = not technically eligible (alternatives discussed).

Same-day eligibility result and consent consultation

The KIMS MRgFUS team (neurologist + neurosurgeon) reviews all assessment data and provides a same-day eligibility decision. If eligible: a detailed consent consultation covering the procedure, expected benefits, risks, and what the treatment day involves. Questions are answered fully. Procedure scheduling and pre-procedure instructions are provided. If not eligible: alternatives (DBS, RF thalamotomy) are explained.

Phase 3

Preparing for Treatment Day

What to do the day before

Wash your hair thoroughly — the scalp must be completely clean and free of hair products · Do not apply any hair products (gel, oil, cream) the day before or on the day of treatment · Continue all regular medications unless specifically instructed to hold any · Fast from midnight (no food or milk; water and essential medications permitted).

What to bring on treatment day

A family member or friend who can accompany you — you will not be able to drive yourself home (mild sedation may be given) · All previous MRI films and reports · Your medication list · Loose, comfortable clothing (hospital gown will be provided) · A book, music playlist, or podcast to listen to during the planning phase (when you are waiting in the frame while the team designs the plan) · For patients from outside Hyderabad: accommodation arrangements for the night after treatment are recommended (staying in Hyderabad for one night before travelling back is advisable for most patients).

Phase 4

Treatment Day — Step by Step

The full treatment-day timeline from 7:30 am arrival to 2:30 pm discharge — showing the sequence, duration, and purpose of every stage.

Time

What Happens

Duration

7:30–8:00 am

Arrive at KIMS · Check-in · IV cannula · Consent review · Pre-medication

30 min

8:00–8:30 am

Head shaving (the entire scalp is shaved for the helmet fitting) and scalp preparation

30 min

8:30–9:00 am

Stereotactic frame application under local anaesthetic

20–30 min

11:00 am–1:00 pm

Ultrasound treatment in MRI scanner: low-energy sonications → therapeutic sonications

60–120 min

1:00–1:30 pm

Post-treatment MRI (confirms lesion, excludes complications)

30 min

1:30–2:00 pm

Frame removal · Clinical assessment · Light meal · Observation

30 min

2:00–2:30 pm

Final review by neurosurgeon · Discharge instructions · Discharge

30 min

Inside the Scanner

What the Patient Experiences During the Sonications

The first (sub-therapeutic) sonications — the moment of first hope

The first several sonications at KIMS are delivered at sub-therapeutic temperatures — enough to temporarily suppress neuronal activity in the target area but not enough to create a permanent lesion. During these sonications, many patients experience a partial reduction in their tremor — sometimes dramatic. The neurologist asks the patient after each sonication: “How does your tremor feel? Can you hold your hand out?” The patient is asked to trace the Archimedes spiral again. For patients who have lived with an uncontrolled tremor for years or decades, the moment when they look at their hand and see it barely moving — still on the treatment table, still inside the MRI machine — is often described as one of the most significant moments of their lives. Not everyone experiences the full effect during the sub-therapeutic phase (the effect at lower energies is not always complete) but many do.

The therapeutic sonications — creating the permanent lesion

Once the team is satisfied that the target location is confirmed (by thermometry, by patient feedback, and by the clinical tremor assessment during sub-therapeutic sonications), the energy is increased to the therapeutic range: 55–60°C for 10–15 seconds. The patient may feel a transient warmth in the head. The team monitors the thermometry map continuously. After each therapeutic sonication, the patient is assessed again. Typically, 2–6 therapeutic sonications are required to create the full lesion, with small adjustments between sonications based on the clinical and thermometry responses. When the lesion is complete, the tremor is dramatically reduced or absent. The team asks the patient to again trace the Archimedes spiral: the improvement is usually strikingly visible.

What side effects may occur during treatment

During the sonications, patients may experience: (1) Transient tingling or numbness in the face, lip, hand, or tongue: indicates the focal zone is touching a sensory pathway adjacent to the Vim. The patient reports this, the team adjusts the target, and the sensation resolves within seconds of the sonication ending. (2) Transient vertigo or nausea: from heating near vestibular thalamic pathways. Resolves within seconds. (3) Mild unsteadiness when asked to stand: common after the initial sonications, usually improves with time. (4) A brief, intense feeling of warmth in the head: from skull heating during sonication. Resolves within seconds. None of these sensations represent permanent injury — they are the real-time feedback system that guides target adjustment.

Phase 5

Recovery and Follow-Up

Immediately after treatment (first 24 hours)

Most patients go home on the day of treatment. Discharge is typically 3–4 hours after the treatment sonications are completed. Common post-procedure experiences: a mild headache from the frame pin sites (managed with paracetamol) · Fatigue · Mild scalp tenderness · Occasional nausea. The tremor: typically dramatically improved from the pre-treatment level. Most patients can pour a glass of water, eat with a spoon, or write legibly on the day of treatment — activities that may not have been possible for years. Do not drive on the day of treatment.

First week after treatment

Rest for 1–2 days · Hair will begin to regrow (the shaved scalp is a temporary change) · The scalp pin site marks are small and heal within 1–2 weeks. Some patients experience mild unsteadiness in the first week: this is from the procedure and improves spontaneously in most patients within 1–4 weeks · A small number of patients experience temporary sensory changes (tingling, numbness) in the face or hand: these usually resolve within 4–8 weeks. Resume normal activity gradually as tolerated. No driving for 1 week or until cleared by the KIMS team.

Follow-up schedule

1-month follow-up: clinical assessment (tremor scoring, functional tasks, Archimedes spiral) · Can be conducted by video consultation for out-of-Hyderabad patients · 3-month follow-up: MRI of the brain (confirms lesion characteristics at 3 months when post-treatment oedema has resolved) · Clinical assessment · Can be MRI at a local centre with images sent to KIMS · 12-month follow-up: the standard clinical trial follow-up point · Tremor reassessment · Functional status review. In-person visit preferred for the 12-month assessment.

For Patients Travelling From Outside Hyderabad

Travel Planning and Remote Follow-Up

Combining the eligibility visit and treatment — a 2-day itinerary

For patients travelling from Vijayawada, Visakhapatnam, Tirupati, Nellore, or other cities in AP and Telangana, KIMS offers a 2-day combined itinerary: Day 1: Eligibility assessment (clinical evaluation + MRI + head CT + SDR calculation + consent consultation) · Accommodation in Hyderabad overnight. Day 2: MRgFUS treatment · Same-day discharge · Travel home the same evening or the following morning. This itinerary minimises total travel required. The KIMS team accommodates this scheduling when requested. Call 040-44885000 to arrange.

Remote follow-up options

1-month follow-up: video consultation with the KIMS team · 3-month MRI: performed at any MRI centre in AP or Telangana with DICOM images sent to neuroscience@kimshospitals.com · 12-month in-person visit: preferred for a complete assessment · Between appointments: direct phone and email access to the KIMS MRgFUS team for any concerns. The single treatment day and remote follow-up model makes MRgFUS at KIMS practically accessible for the vast majority of patients in the region, regardless of distance.

Key Clinical Facts

What Patients Should Know

The MRgFUS journey at KIMS is built around a same-day treatment and remote follow-up model that makes the procedure practically accessible across AP and Telangana. The following points summarise the most clinically significant facts every patient and family should know.

Total MRgFUS treatment-day duration at KIMS: 7:30 am arrival to 2:30 pm discharge — a same-day procedure for most patients

Tremor improvement is often visible during sub-therapeutic sonications — many patients watch their hand stop shaking while still on the treatment table

Therapeutic sonications use 55–60°C for 10–15 seconds — typically 2–6 sonications are required to create the full Vim thalamic lesion

Transient tingling, vertigo, nausea, or warmth during sonications resolves within seconds — these are the real-time feedback signals that guide target adjustment

Most patients can pour water, eat with a spoon, or write legibly on the day of treatment — activities that may not have been possible for years

Scalp hair grows at approximately 1–1.5 cm per month; 3–4 cm of regrowth is typical by 3 months

No driving on the day of treatment; resume after 1 week or when cleared by the KIMS team

Out-of-Hyderabad 2-day itinerary: Day 1 eligibility + overnight stay · Day 2 treatment + same-day discharge — covering patients from Vijayawada, Visakhapatnam, Tirupati, Nellore, and other AP/Telangana cities

Key Facts

The MRgFUS Patient Journey at a Glance

Fact	Details
5-phase journey	Phase 1: First contact (phone/email pre-screening) · Phase 2: Eligibility assessment (1 day, same-day result) · Phase 3: Treatment day preparation · Phase 4: Treatment day (7:30am–2:30pm approx) · Phase 5: Recovery and follow-up
Treatment day timeline	7:30am: Arrival · Scalp shave · Frame (local anaesthetic) · Pre-treatment MRI · Planning (sub-therapeutic sonications) · Therapeutic sonications · Post-treatment MRI · Frame removal · ~2:30pm: Discharge
Recovery	Same-day discharge for most patients · Light activity in 1–3 days · Balance-dependent activities wait 2–4 weeks · Follow-up: 1 month (video), 3 months (local MRI), 12 months (in-person at KIMS)
Out-of-Hyderabad patients	Combined 2-day itinerary: eligibility day 1, treatment day 2 · Patients from AP, Telangana, Karnataka, Odisha welcomed · 1-month follow-up by video clinic · 3-month MRI can be done locally
Day-before checklist	Wash hair (no conditioner or hair products) · Fast from midnight · Bring: companion, MRI films, CT scans, medication list, music/podcasts · Written checklist sent by KIMS after eligibility visit
Post-procedure emergency	New or worsening neurological deficit · Severe headache unresponsive to paracetamol · Persistent unsteadiness · Call 040-46324365 immediately (24×7)
Contact	040-44885000 · neuroscience@kimshospitals.com · No referral needed · Out-of-state patients: combined 2-day visit available

Related Treatments

Explore related MRgFUS, DBS, and Gamma Knife pages at KIMS Neuroscience:

MRgFUS Focused Ultrasound Who is Eligible?Deep Brain Stimulation Gamma Knife Radiosurgery

Common Questions

Frequently Asked Questions

The entire scalp is shaved before the Exablate Neuro helmet is fitted — this is required for acoustic coupling between the ultrasound transducers and the scalp. The shaving is done by the KIMS nursing team on the morning of the procedure and takes approximately 30 minutes. Hair regrowth: scalp hair grows at approximately 1–1.5 cm per month. By 3 months after the procedure, most patients have 3–4 cm of hair; full hair length (if the hair was previously long) typically returns within 6‒9 months. In the weeks immediately after the procedure, the shaved scalp is usually covered with a hat, headscarf, or turban as preferred. Many female patients who have planned ahead choose a short haircut in the weeks before treatment to make the regrowth period more manageable. The KIMS team can discuss practical approaches based on individual preference. Call 040-44885000.

Claustrophobia is a common concern for patients undergoing MRgFUS, and the KIMS team addresses it proactively. Practical mitigations: (1) The open end of the MRI bore faces the patient, and the team is visible and audible through the intercom throughout the procedure. (2) Music, podcasts, or audiobooks can be played through MRI-compatible headphones during the scanning and treatment phases. (3) An anxiolytic medication (oral diazepam 5–10 mg or lorazepam 1–2 mg) can be given before the procedure. (4) The patient can request a pause and temporary withdrawal from the MRI bore at any point during the procedure — the Exablate Neuro system accommodates brief pauses without compromising the treatment. (5) The team members maintain continuous verbal communication throughout, providing frequent updates on progress. For most patients with mild to moderate claustrophobia, these measures are sufficient. For patients with severe, phobia-level claustrophobia (inability to tolerate MRI even with sedation), MRgFUS may not be feasible, and DBS should be considered. A test MRI visit before the treatment day can help clarify tolerability for anxious patients. Call 040-44885000.

The MRgFUS thalamotomy targets the thalamus on the side opposite to the tremoring hand. For a right-handed patient whose right hand trembles, the left Vim thalamus is targeted. For a left-hand tremor, the right Vim thalamus is targeted. If your most functionally disabling tremor is in the left hand (even though you are right-handed), the treatment targets the right thalamus for the left hand tremor. In patients with tremor in both hands where one hand is significantly more affected than the other, treatment of the more affected side is recommended first. If the result is satisfactory, the decision about whether to treat the other side (with DBS, since bilateral MRgFUS is not recommended) can be made at a later stage. The movement disorders team at KIMS will advise on the optimal treatment strategy for bilateral tremor at your eligibility assessment. Call 040-44885000.

Most patients return to normal light activities within 1–3 days of treatment. Specific activities: (1) Eating and drinking: improved immediately after treatment — most patients have a meal on the treatment day using utensils that may have been difficult for years. (2) Writing and fine motor activities: improved immediately, continuing to improve over the first 1–2 weeks as post-procedure oedema resolves. (3) Driving: not on the day of treatment (pre-procedure medication) · resume after 1 week or when cleared by the KIMS team · if significant unsteadiness is present, driving is delayed. (4) Work (desk/office): most patients return within 3–5 days. (5) Physical work or exercise: gentle activity from day 3–7; more strenuous activities after 2 weeks. (6) Alcohol: avoid for 2 weeks (worsens tremor and can mask improvement assessment). The improvement seen immediately after treatment is usually the minimum — the lesion continues to mature over the first 1–3 months, and some patients see additional improvement during this period. Call 040-44885000.

From the First Phone Call to a Hand That No Longer Shakes — MRgFUS at KIMS Hyderabad.

From the first phone call to going home with a hand that no longer shakes: the MRgFUS journey at KIMS Hyderabad is designed to be as manageable as possible for patients and families, whether you live in Hyderabad or travel from anywhere in AP and Telangana. Call 040-44885000 to begin.

040-44885000

International enquiries: info@kimsneurosciences.com