Mark Hunter spent 25 years working as a police officer, but it was essential tremor, not the job, that eventually made his hands shake so badly that using a screwdriver or flipping pancakes became a struggle. Last week, Hunter became the first patient to undergo a newly introduced focused ultrasound treatment at MedStar Franklin Square Medical Center in Baltimore, a procedure that required no incision, no implanted hardware, and let him walk out of the hospital the same day.
Hunter's case marks the debut of focused ultrasound technology at the hospital, according to a MedStar Health announcement distributed through PR Newswire. The treatment uses highly concentrated sound waves, guided by real-time MRI imaging, to precisely target a small structure deep in the brain called the ventral intermediate nucleus of the thalamus, creating a controlled lesion that disrupts the abnormal signals associated with tremor. As reported by the Dundalk Eagle, MedStar Franklin Square celebrated the opening of a dedicated focused ultrasound suite meant to expand community access to the treatment and help patients figure out whether it might suit them.
A Procedure Done Wide Awake
Dr. Justin Martello, chief of Neurology for the Baltimore region, performed Hunter's procedure in just over two hours at Franklin Square, per the same MedStar account. Unlike deep brain stimulation, which requires surgery to implant electrodes in the brain, focused ultrasound needs no incision or hardware at all, and patients stay awake the entire time while physicians monitor their response. The announcement notes that improvement can sometimes be seen while the treatment is still underway, and Hunter went home the very same day his procedure wrapped up.
Hunter described the difference between his treated hand and his untreated hand as dramatic, the MedStar account states, and he now plans to undergo focused ultrasound on his other hand as well. Essential tremor commonly causes involuntary shaking in the hands and can interfere with eating, drinking, writing, and other fine motor tasks that most people take for granted. “Essential tremor is one of the most common movement disorders, and its impact on everyday life varies dramatically,” Martello said, according to the release. He added that additional treatment options “can make a meaningful difference for patients who have struggled to find adequate relief.”
Millions Affected, Many Untreated
The scale of the condition is larger than many realize. Essential tremor affects approximately seven million Americans, per published research cited in the MedStar announcement, and that figure may actually undercount the real total since some people never seek medical attention for their tremor at all. Medications help some patients, but others continue to experience symptoms that chip away at quality of life even while on treatment.
A retrospective claims-data analysis published in Advances in Therapy found that roughly 1 million people with essential tremor sought pharmacologic treatment in the United States between 2015 and 2019, while projected population estimates suggested closer to 2 million diagnosed overall. That same analysis found two-year medication discontinuation rates of approximately 40%, underscoring why many patients eventually look beyond pills for relief.
How the Science Has Played Out in Trials
Focused ultrasound is not brand new to medicine broadly, even if it is new to Franklin Square. A 2025 narrative review in the Journal of Movement Disorders notes the technique was first used to treat movement disorders, particularly tremor, back in 2013, and describes MRI-guided focused ultrasound as a noninvasive procedure that avoids incisions, burr-hole trephination, or electrode insertion altogether.
Clinical trial data back up the approach's effectiveness, at least for essential tremor specifically. A double-blind trial conducted at eight international centers and published in the New England Journal of Medicine randomly assigned patients with medication-refractory tremor to either focused ultrasound thalamotomy or a sham procedure in a 3:1 ratio. At three months, hand-tremor scores in the thalamotomy group dropped from 18.1 to 9.6 points, compared with a much smaller shift from 16.0 to 15.8 in the sham group, a between-group difference of 8.3 points. That improvement largely held up at 12 months, with a 7.2-point change from baseline still measured in the treated group.
The same trial reported real tradeoffs, however. Gait disturbance occurred in 36% of thalamotomy patients and paresthesias or numbness in 38%; those effects persisted at the one-year mark in 9% and 14% of patients, respectively. Johns Hopkins Medicine separately notes that results vary from patient to patient and that tremor can worsen in some people after the procedure, and that unlike deep brain stimulation — which can be adjusted over time through reprogramming — focused ultrasound is a one-time procedure with permanent effects.
Not the Only Option in Maryland
Franklin Square is not the first hospital in the state to offer this kind of treatment. Focused ultrasound has also been discussed as a treatment for Parkinson's disease. What MedStar emphasizes as distinct about its own program is Martello himself: his MedStar Health physician profile describes him as the only neurologist in the country trained to perform MRI-guided focused ultrasound without neurosurgery involvement.
For now, Hunter's case stands as the first data point in what MedStar Franklin Square hopes will become an expanding local option for patients whose tremor medications have stopped providing adequate relief. Clinical studies cited in the MedStar release point to significant, lasting improvement in tremor and other movement symptoms following the procedure, though the hospital's own account of Hunter's case has not been independently verified beyond its own announcement.
