PATIENT STORIES Local Artist Paints Again After Gamma Knife Radiosurgery

A self-proclaimed lifelong student of art, 79-year-old painter Fred Ekman has travelled the world painting and teaching his craft to others. The artist's iconic watercolors depict Northern California landscapes, Spanish missions, French architecture and South Pacific seascapes. Now retired, he lives with his wife of 58 years in Sun City Lincoln Hills and enjoys teaching classes to aspiring painters.

When he began experiencing uncontrollable hand tremors about seven years ago, painting became nearly impossible for the acclaimed artist. Ekman was diagnosed with essential tremor, a nervous system disorder that causes rhythmic shaking, and was referred to Nicklesh Thakur, M.D., a neurologist who specializes in movement disorders at the Sutter Neuroscience Institute.

"The essential tremor brought my painting to a standstill," Ekman says, who had already been living with another neurological condition—trigeminal neuralgia—since 2000. Trigeminal neuralgia causes extreme and unexpected pain flare-ups in the face and is sometimes mistaken for a toothache or sinus problem. Ekman had been on the anti-seizure medication Tegretol for several years to control his nerve pain.

To calm Ekman's shaking hands, Dr. Thakur prescribed Primidone, another anti-seizure medication that is also effective in controlling essential tremor. The medication did suppress his tremors. However, both medications had several undesirable side effects. "I felt off-balance, drowsy and fatigued," Ekman says. "All I wanted to do was sleep."

Tired of feeling unsteady and exhausted, Ekman talked to Dr. Thakur to explore alternative treatments for his essential tremor so that he could paint once again. Dr. Thakur recommended Deep Brain Stimulation (DBS), a surgical treatment involving the implantation of a medical device called a brain pacemaker that sends electrical impulses to the brain to stop the tremors.

Unfortunately, shortly before his DBS treatment, Ekman encountered unrelated health problems and the surgery had to be cancelled. Because Fred now had a pacemaker to treat congestive heart failure, he was no longer a candidate for DBS.

A short time later, Dr. Thakur suggested Ekman consider Gamma Knife radiosurgery to treat his trigeminal neuralgia. Fred met with Samuel Ciricillo, M.D., a Sutter Neuroscience Institute neurosurgeon, and learned that Gamma Knife radiosurgery is a safe, effective outpatient procedure using highly focused beams of radiation that target specific areas of the brain without damaging surrounding tissue.

On the day of the procedure, Ekman was fitted with a lightweight frame designed to stabilize his head and help team members focus the radiation beams to precisely target the trigeminal nerve. With the help of imaging, the team used three-dimensional, computerized technology to figure out exactly where to administer the radiation. Once this was determined, the 90-minute Gamma Knife procedure took place. Ekman was able to go home later that afternoon and felt immediate relief from his nerve pain.

"I was anxious not knowing how much discomfort I'd be in, but I actually fell asleep during the procedure," Ekman says. "It was a piece of cake."

About a month later, Ekman received more good news. "I got a call from Dr. Ciricillo's office asking if I'd like to consider Gamma Knife to treat my essential tremor," he says.

After the success of his first Gamma Knife treatment, it was an easy decision for Ekman. The second treatment went as smoothly as the first one, and he is now completely off of the medications for both his essential tremor and trigeminal neuralgia.

Ekman and his wife recently returned from a cruise to Hawaii, where he spent much of his time painting aboard the ship. The artist is grateful for the care that allowed him to return to painting, teaching and an active lifestyle. "I was very confident in Dr. Ciricillo and the rest of the Gamma Knife team. Had I not been, I'd still be on medications and living with the side effects," he says.