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Breakthrough Treatment for Essential Tremor

Devin K. Binder, M.D., Ph.D., is using the latest technology for MR-guided Focused Ultrasound procedures on a patient.

Orange Coast Medical Center: The first Orange County hospital to offer a noninvasive treatment for essential tremor and tremor-dominant Parkinson’s disease. 

Deep in the brain lies a tiny structure called the ventral intermediate (VIM) nucleus. Part of a larger structure, known as the thalamus, the VIM nucleus has been identified as the source for treatment of essential tremor, a neurological condition that affects nearly 10 million Americans.


Essential tremor causes uncontrollable shaking of one or both hands and may also affect the head, voice, torso and legs. For some, the shaking is constant and debilitating, interfering with everyday activities, such as dressing, eating and drinking, and writing.


Medications have been developed to treat essential tremor but can be ineffective or have unwanted side effects. If patients are unresponsive to medication or other traditional treatments and have been differentially diagnosed as suffering from essential tremor, they can receive a comprehensive evaluation to determine if they are a candidate for
magnetic resonance (MR)-guided Focused Ultrasound, an incisionless procedure that can reduce or eliminate the tremor.


What is MR-guided Focused Ultrasound?
MR-guided Focused Ultrasound combines two advanced technologies: focused ultrasound and magnetic resonance imaging (MRI). MRI delivers real-time 3D images of the patient’s brain that allow the neurosurgeon to target the VIM nucleus and accurately deliver simultaneous beams of ultrasound. The beams pass through the skin and skull to intersect at the targeted location, heating the tissue and creating a small burn, called an ablation, which provides a therapeutic effect.

“The patient is awake and actively participating in their treatment,” says Devin K. Binder, M.D., Ph.D., neurosurgeon at Orange Coast Medical Center. “Before the procedure, we evaluate the severity of their tremor through simple tasks, such as handwriting, holding a cup, or drawing spiral diagrams. We have them repeat these tests periodically and continue with the procedure until their tremor has been suppressed.”

The outcomes of this two-hour procedure are immediate. Often, patients who could not hold a fork or pen in their dominant hand prior to the procedure are able to eat independently and sign their names clearly afterward. With no incisions involved in the treatment, recovery times are quicker than a traditional neurological surgery, and patients are able to resume normal activities within a few days.


Flagship program
Orange Coast Medical Center is one of only two hospitals in Southern California to offer MR-guided Focused Ultrasound for intervention of essential tremor. The treatment is covered by Medicare, making it more accessible for patients who need it.


“Tremor reduction is immediate and life-changing with this procedure. Patients are able to regain their independence, which improves the quality of their life,” says Theresa Stern, M.P.T., director of the MemorialCare Neuroscience Institute at Orange Coast Medical Center.

For more information on the MR-guided Focused Ultrasound Program at Orange Coast Medical Center, please visit

Keeping Steady

Dr. Binder and the Orange Coast team made me feel so comfortable and confident – I just knew it would work,” says Esther. “They had me sign my name before the procedure and several times during. My writing improved each time, and by the end, it was the signature I knew before my tremor began.


After 12 years of living with essential tremor, Esther Doyle’s condition suddenly worsened. The active 73-year-old was no longer able to hold a fork and everyday activities, such as cooking, became challenging. Eventually, she had to give up her part-time role of caretaker for her two grandchildren.


When medication failed to suppress the tremor, Esther began researching breakthrough treatments and happened upon magnetic resonance (MR)-guided Focused Ultrasound. Only two hospitals in Southern California perform this procedure, and Orange Coast Medical Center was the closest – an almost two-hour drive from Esther’s home in Ramona, California, which she described as “worth every minute.”


Esther contacted the office of Devin K. Binder, M.D., Ph.D., neurosurgeon at Orange Coast Medical Center, for a consultation. With over 20 years of experience treating patients with movement disorders, Dr. Binder has also performed over 500 deep brain stimulation (DBS) surgeries – a noninvasive procedure for essential tremor, in which electrodes are implanted into certain brain areas. On November 3, 2020, Dr. Binder performed the first MR-guided Focused Ultrasound procedure at Orange Coast Medical Center on Esther. That same day, the tremor in Esther’s dominant hand was no longer active, and now she is back to her active self. 

For more information about MR-guided Focused Ultrasound at Orange Coast Medical Center, please visit


The Parkinson’s and Movement  Disorders Disease Program


In 1997, Daniel D. Truong, M.D., neurologist at Orange Coast Medical Center and president of the International Association of Parkinsonism and Related Disorders (IAPRD), founded the Parkinson’s and Movement Disorders Disease Program at Orange Coast Medical Center. The program is dedicated to a full spectrum of patient care and clinical research.

Since its inception, Dr. Truong and his associates have treated more than 2,000 patients; published six textbooks; and contributed to over 180 scientific articles in peer-reviewed journals. In addition, they share their research findings and expertise through lectures and seminars around the world.


“We are heavily involved in clinical research studies, so our patients have access to the most promising new treatments, including magnetic resonance (MR)-guided Focused Ultrasound,” says Dr. Truong. “We have a team of highly trained specialists in neurology who are providing advanced and individualized care.”

To learn more about the program and how it’s on the forefront of MR-guided Focused Ultrasound, visit


MemorialCare Welcomes OC Blood & Cancer Care

As of February 1, 2021, OC Blood & Cancer Care has chosen to join MemorialCare Medical Group. With more than 15 years of providing high-quality care to the community, these highly respected physicians will bring their experience and knowledge to MemorialCare’s comprehensive cancer programs. As leading providers of comprehensive cancer and blood disorder treatment, these physicians have spent years specializing in developing and coordinating treatment programs designed and targeted for each individual patient.


MemorialCare Cancer Institute, led by a team of dedicated and highly skilled oncologists and specialists, is committed to staying on the leading edge of cancer research and is involved in more than 100 of the world’s most promising research protocols. The addition of OC Blood & Cancer Care, with two locations in Orange County and a strong focus on cancer research, will continue our mission to drive cancer care forward.


OC Blood & Cancer Care physicians:


To learn more, find a location or schedule an appointment, please visit or call (714) 378-7330.

MemorialCare-OCMC (White + Color Leaf).p
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