I recently had the Focused Ultra Sound Insightec USS Treatment for Essential Tremor, here are my notes. Have had slowly worsening tremor for about 15 years, Primidone had harsh side effects and propenal was only slightly helpful.

Treatment was done 2/21/2025, 11 days ago to the left side brain to treat right hand, also hopeful that it would help head tremor. Head tremor was much worse than hand tremor prior to surgery and was my underlying motivation for trying the surgery. Hand tremor was definitely present but not as much of a quality of life issue.

I am beyond thrilled with the results!
Right hand tremor is effectively gone 95%
Head tremor down 85%
With my right hand I can use chopsticks, touch pad on the computer without double tap and handwriting is 95% smooth. Note- I have always had really bad handwriting, it is still bad!
Left hand unchanged
Right hand operations will take time to adjust to the new normal, using the touchpad on the phone is different and I am making new types of errors as I adjust. I fully expect that these will easily get better over time.

Treatment
Applying head cage not quite enough local anesthetic was used at first on two back screws. Dose was increased but my best guess is not enough wait time was given for it to be effective. So a 3rd dose was administered. It was fine but the residual was not entirely gone for at least 12 hours. Just annoying, not a big problem.
I got an anti-inflammatory injection both before and after the procedure (Dexamethasone? I am pretty sure). Significant dizziness after both injections. I needed to be wheeled to the procedure room.
Written test first then trial sound wave procedure. After another written test, hand improvement was immediately obvious. Did permanent intensity procedure and another written test, same result.
After the last written test I still had a few slight deviations from straight lines but huge, huge improvement.
No side effects or lip tingles felt.
Doctor asked how I felt and if I thought enough was done. That was a really hard question, I think it is a necessary question and looking back on it, would having repeated the treatment and upped it a little bit gotten rid of the last residual on my hand? Maybe, but would it also open me up to possible side effects? Really tough question. I told him I was good, I am sure I will second guess that. Just to repeat the treatment was awesome and really effective, I am so glad I did it!
Because of the head cage there was no chance to see the effect on the head tremor after test soundwaves and final.
Recovery
I was dizzy and weak for several hours afterwards, eating and drinking helped. I believe it was a reaction to anti-inflammatory injection, not the procedure.
After eating I noticed how the head tremor had relaxed and was pretty much gone. Awesome!
That night I had an alcoholic drink to celebrate, a mistake with the Dexamethasone. Heartburn, hiccups and unusual awakeness.
Filled prescription for Dexamethasone- 4mg, 2 times a day 5 days then 1 time a day 5 days to start morning after the surgery.
Accidentally took 2 pills in the morning after surgery, horrible heartburn, hiccups, disturbance in sleep patterns.
Waited 24 hours for the next single dose. Slightly improving side effects but still bad
Took 2 pills a day for 3 days total (side effects too strong for two a day), then the last 7 days one pill per day. Side effects have improved but still some balance issues for several hours after taking the pill. Still some sleep disruptions. Last pill of the 10 days taken this morning.
Can I try to stop propanol? doctor says lower the dose to one for the next month.
Ghost tremors- I still have head movement sometimes but it is much easier to control, it feels like if I relax I can stop it or slow it down.
Regarding the 9 month wait for other side treatment, it probably is longer than necessary for the physical recovery (says one patient very early on) however I can see the merit in letting your muscles adjust to the new normal over time. Things are different and require relearning and strengthening. So in my case I don’t see a need to rush it.
Good side effect from Dexamethasone was that my enlarged Prostate shrunk when taking the drug causing me to urinate normally. I am under the care of a Urologist for it, my next procedure will likely be Aquablation for it. It is fun getting old!