For Ana Gutierrez Larez, simple acts like sipping soup or signing her name were sources of trauma. Since childhood, she had lived with essential tremor (ET), a condition that caused her hands to shake uncontrollably. “I suffered a lot,” she recalls.

Her tremors made everyday tasks a public struggle. Going to a restaurant was an ordeal, Often, her husband, Fernando, would have to help her eat so others wouldn’t notice her shaking. “I couldn’t have soup. No, no, no, it was trauma,” she says.

After more than 50 years of living with her condition, Ms. Larez found life-changing relief through a non-invasive procedure at Baptist Health Miami Neuroscience Institute.

Using high-intensity focused ultrasound (HIFU), neurosurgeon Justin Sporrer, M.D., the Institute’s director of functional neurosurgery, was able to give her the steady hands she had longed for her entire life. Her story shines a light on a treatment that offers immediate, profound results for a condition that affects millions.

Understanding Essential Tremor (ET)

Essential tremor is a neurological disorder that causes involuntary, rhythmic shaking. Unlike the tremors associated with Parkinson's disease, ET is typically an “action tremor.”

As Dr. Sporrer explains, “It’s really most noticeable with activity.” This means the shaking worsens when a person tries to perform an action. “When they try to pick up a glass, a fork or a spoon, when they try to write or use a mouse, all of those things are greatly affected,” he says of patients like Ms. Larez.

ET Affects Roughly 7 Million U.S. Adults

According to the Journal of the American Medical Association (JAMA), the number of people in the U.S. suffering from ET is estimated around 7 million, although the actual number is believed to be closer to 10 million, as milder cases often go undiagnosed or unreported. ET’s prevalence is lower in younger adults but rises significantly in adults 60 years of age or older.

Many people live with ET for decades before seeking treatment, says Dr. Sporrer. “They become adept at managing their symptoms, and since the condition is often genetic, they may see it as a family trait they simply have to endure.”

For Ms. Larez, it took her husband’s persistence and seeing the success of a friend’s treatment to convince her to seek help. “I would tell him, ‘Don’t worry, at my age, just let it be.’” But Mr. Larez was determined to get his wife the care she needed.

A Perfect Candidate for a Precise Procedure

While there are many types of tremors, HIFU is particularly effective for essential tremor. This precision-based approach offered a path to relief without the risks of traditional surgery. According to Dr. Sporrer, the most critical factor for a successful outcome is a correct diagnosis.

“In Ms. Larez’s case, she had been diagnosed with essential tremor and that, along with her age and medical history, made her an ideal candidate for HIFU over more invasive options like deep brain stimulation (DBS),” which is another treatment option for some patients with ET and other movement disorders.

How HIFU Quiets the Tremor

Dr. Sporrer explains the science behind HIFU with a simple analogy. “I tell patients it’s like a magnifying glass,” he says. “The procedure uses up to a thousand individual beams of low-energy ultrasound, all pointed at a single, precise spot in the brain. Separately, the beams are harmless. But where they intersect, their combined energy is powerful enough to raise the temperature and create a tiny ablation, or lesion.”

The goal, he says, is to target a specific cluster of brain cells in the thalamus that are responsible for the tremor.

“In people with essential tremor, they have a population of neurons, or brain cells, that for whatever reason have this abnormal rhythm,” Dr. Sporrer explains. “Our goal is to cause an ablation, or in layman’s terms, kill those neurons.” By interrupting this faulty brain circuit, HIFU effectively silences the tremor.

The entire procedure is done while the patient is awake, which allows the medical team to test the results in real time. No incisions or anesthesia are required beyond local numbing for the “halo” head frame required to keep the patient’s head perfectly still during their treatment.

“After each round where we’re delivering the ultrasound, I’m talking to the patient and having them try to draw a spiral while staying within the lines.” says Dr. Sporrer. “We’re also testing for any kind of side effects in real time.” This immediate feedback allows for micro-adjustments, ensuring the “sweet spot” is targeted for maximum benefit with minimal risk.

A Life Transformed One Hand at a Time

The results are not only precise—they’re immediate. “There are very few occasions as a physician where you can see immediate results for a condition somebody has had their entire life,” Dr. Sporrer says.

Ms. Larez experienced this firsthand. After her dominant hand was treated, she saw the shaking stop completely while her other hand continued to tremble. The contrast was stark. Nine months later—a requirement to allow the brain to heal—she returned to treat her second hand.

The thought of the initial numbing injections for the head frame made her hesitant but the promise of a life free from tremors in both hands was a powerful motivating force. “I said, ‘Okay, I’ll go for the second time.’ And, well, here we are!” 

Now, both of Ms. Larez’s hands are steady and her quality of life is remarkably improved. “Now I can go to a restaurant without people looking at me as I eat,” she says with visible joy. For her husband, the change is just as moving. “I think I’m happier than you because I practically had to feed you at the restaurant so no one would see your tremor,” he tells his wife.

The emotional impact on patients is profound. Dr. Sporrer describes the moments after the procedure as deeply satisfying. “Watching them laugh or even cry at the idea that now they can sign their name—and they haven’t done that in decades—there’s really nothing like that from a neurosurgeon’s perspective,” he says. “This is a happy day for the patient and for the surgeon.”

For Ms. Larez, the feeling is simple and overwhelming. “It’s a happiness that I hadn’t felt for many years, truly,” she says, her gratitude evident. “First, I thank the Lord and also Dr. Sporrer. He is a truly wonderful person, attentive and concerned that everything goes well. And I thank my husband, Fernando, who also helped me a lot and insisted I have this procedure.”

Says Mr. Larez: “Seeing my wife without tremors after more than 50 years and how she can manage to hold a cup of coffee is a wonderful thing.”

To learn more about high intensity focused ultrasound (HIFU) for the treatment of essential tremor (ET), click here