Downton Abbey creator Julian Fellowes treated for essential tremor with focused ultrasound
Fellowes underwent an FDA-approved noninvasive procedure in May to address a tremor that had limited daily tasks, marking a rare public account of a long-held condition being treated with a breakthrough therapy.
Julian Fellowes, the creator of Downton Abbey, says he cured a tremor that he long believed was incurable through a noninvasive MRI-guided focused ultrasound procedure. The 76-year-old writer and producer underwent the treatment in May to address essential tremor, a neurological disorder that disrupts voluntary movement. During the surgery, he was awake and monitored by clinicians as doctors targeted tremor-producing tissue in the brain. He described the experience as terrifying yet revolutionary, and said the outcome was almost immediate.
Essential tremor causes rhythmic shaking most often in the hands and arms, and can disrupt tasks such as eating, writing, and buttoning a shirt. Fellowes told The Times that the tremor worsened with movement and that cufflinks would fly off his sleeves, sometimes making everyday tasks depressing and upsetting. “Doing up buttons, fastening a tie — everything became a labor. My cufflinks would go flying off,” Fellowes said in an interview with The Times. “It is very, very depressing and upsetting.”
Experts aren’t exactly sure what causes essential tremor, but researchers point to changes in specific brain circuits. The Cleveland Clinic notes that while essential tremor often runs in families, about half of cases are inherited. At present there is no known way to prevent the condition.
Treatment has expanded in the past decade. Options include medication, physical therapy, assistive devices and deep brain stimulation. Focused ultrasound thalamotomy for essential tremor received FDA approval in 2016. In May, Fellowes underwent the noninvasive procedure that uses MRI-guided ultrasound beams to destroy tremor-producing tissue while sparing surrounding areas. He described the head-crown device that keeps the head still as uncomfortable, but said doctors could monitor his responses as the treatment progressed. The operation was described as an almost immediate success.
Within a month, Fellowes said he could write again and even drink from a glass, a task he had avoided for years. “That’s quite strange, actually, because I haven’t trusted myself to do that for some time,” he told The Times. A 2022 study found patients with essential tremor who underwent focused ultrasound thalamotomy had a 73% reduction in shaking severity five years after treatment, a finding that researchers described as encouraging for durable relief.
Fellowes said he is not alone and wants to raise awareness about a condition that affects roughly 1 in 5 U.S. adults over the age of 65. “I’ve had the treatment and I’ve, in a sense, cured the tremor in my right hand. And I want people to know that,” he said. “I hope that I can be of some small use in getting it known.”
