Magnetic Resonance Imaging-Guided Focused Ultrasound Lesioning under General Anesthesia: A Case Series

Introduction: Real-time monitoring during MR-guided focused ultrasound (MRgFUS) procedures has been considered essential to monitor tremor improvement and side effects in the alignment and/or verify phase before the actual MRgFUS treatment and following the ablative sonications. However, a subgroup of patients does not tolerate being awake during the entire procedure for a variety of reasons. Case presentations: We performed MRgFUS treatments in three Parkinson's disease/Parkinsonism patients under general anesthesia. These patients had previously failed an attempt to undergo the procedure awake. All 3 patients who had the procedure under general anesthesia experienced significant improvement of their symptoms and experienced only transient adverse effects (e.g., balance problems, left facial droop) that were no longer evident at their first postoperative visit. Conclusion: Our findings suggest that MRgFUS treatment under general anesthesia could possibly be done safely and may represent a valid therapeutic option for patients unable to tolerate the procedure awake.