Thanks to MRI-guided focused ultrasound, a procedure performed at Rambam Health Care Campus (Rambam) in Haifa, Israel, Motti Ben-Lulu (57) is beating his 30-year battle with severe hand tremors. After the life-changing procedure, he can hammer a nail and pick up spaghetti with a fork.
(L-R) Dr. Alon Sinai, Dr. Ilana Schlesinger, Motti Ben-Lulu, and Dr. Lior Lev-Tov. Photography: Rambam HCC
In his early twenties, Ben-Lulu, a resident of Northern Israel, was diagnosed with essential tremor, a neurological condition causing hand tremors. These tremors make even the simplest task challenging – from eating with a fork, and drinking from a cup, to writing.
However, Ben-Lulu is a fighter by nature and never allowed his condition to get in the way. When the events of October 7 unfolded, he was called up for duty and deployed in the frontlines to carry out reserve duty as a platoon commander in an IDF artillery unit. Four months later, while still serving, he received a call to report to another front—Rambam where he was to undergo a life-changing procedure. “I left the frontlines, from a life-threatening situation to a life-changing one,” he recalls.
Motti Ben-Lulu in the field. Photo courtesy of Ben-Lulu.
“Essential tremor is twenty times more common than Parkinson’s disease. Patients typically suffer from hand tremors, making simple tasks difficult, and the condition can worsen over time,” explains Dr. Ilana Schlesinger, director of the Movement Disorders Institute in the Department of Neurology at Rambam. “We use MRI-guided focused ultrasound (FUS), to safely burn specific brain areas identified as the source of the tremor. In a relatively short procedure (one or two hours), FUS replaces the need for invasive surgery, and there is no need to drill or open the skull surgically.”
A patient may experience tremors in one or both hands, but each side is treated separately. A short while after the procedure, the targeted tremors cease, and the patient is discharged. If needed, after a few months, a second procedure can be performed on the other hand.
“I heard about FUS more than ten years ago,” Ben-Lulu recounts. “My wife researched it on the internet—I kept it in mind but put it aside until recently, when the physicians at Rambam determined I was suitable for the treatment.”
Dr. Alon Sinai, a neurophysiologist in the Movement Disorders Institute who oversees the FUS procedure, points out, “FUS is a highly targeted procedure, and accuracy is crucial. During the procedure, we use MRI-guided imagery to assess the patient’s condition in real-time. In this way, we can achieve the best results.”
Dr. Lior Lev-Tov, an attending physician in the Department of Neurosurgery and a functional neurosurgery expert, explains that treating essential tremors with FUS is covered by Israel’s basket of national health services. “It is also effective in treating other neurological conditions. We also used FUS to successfully treat a patient with Parkinson’s disease, suffering from muscle stiffness, mobility issues, and tremors. It was the first time in Israel that this procedure was performed on multiple sites in a Parkinson’s patient. She had not responded to traditional medical therapies and suffered from severe functional impairment.
The breakthrough procedure changed her life.”
Rambam is one of the few medical centers worldwide to perform FUS and it was recently chosen to lead the way in implementing the next generation of FUS devices developed by Insightec, an Israeli start-up company.
Adjusting to his new life, an optimistic Ben-Lulu, shares, “The effect of FUS is nothing short of a miracle. I’m a new person doing things I never thought possible. Every morning, I check that I’m not dreaming. My friends in the army knew I fill my cup only halfway—otherwise, I would spill my coffee. Now, a new era has arrived—my cup is full.”
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