DEEP BRAIN STIMULATION OF THE ANTERIOR INTERNAL CAPSULE FOR THE TREATMENT OF TOURETTE SYNDROME: TECHNICAL CASE REPORT

被引:142
作者
Flaherty, Alice W. [2 ]
Williams, Ziv M. [1 ]
Amirnovin, Ramin [1 ]
Kasper, Ekkehard [1 ]
Rauch, Scott L. [3 ]
Cosgrove, G. Rees [1 ]
Eskandar, Emad N. [1 ]
机构
[1] Harvard Univ, Massachusetts Gen Hosp, Dept Neurosurg, Sch Med, Boston, MA 02114 USA
[2] Harvard Univ, Massachusetts Gen Hosp, Dept Neurol, Sch Med, Boston, MA 02114 USA
[3] Harvard Univ, Massachusetts Gen Hosp, Dept Psychiat, Sch Med, Boston, MA 02114 USA
关键词
Deep brain stimulation; Internal capsule; Obsessive-compulsive disorder; Tourette syndrome; Ventral striatum;
D O I
10.1227/01.NEU.0000176854.24694.95
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
OBJECTIVE AND IMPORTANCE: Medical treatment of Tourette syndrome is often ineffective or is accompanied by debilitating side effects, therefore prompting the need to evaluate surgical therapies. CLINICAL PRESENTATION: We present the case of a 37-year-old woman with severe Tourette syndrome since the age of 10 years. Her symptoms included frequent vocalizations and severe head and arm jerks that resulted in unilateral blindness. Trials of more than 40 medications and other therapies had failed to relieve the tics. INTERVENTION: We implanted bilateral electrodes in the anterior limb of the internal capsule, terminating in the vicinity of the nucleus accumbens. At 18-month follow-up, optimal stimulation continued to lower her tic frequency and severity significantly. CONCLUSION: Our findings suggest that stimulation of the anterior internal capsule may be a safe and effective procedure for the treatment of Tourette syndrome.
引用
收藏
页码:ONS / 403
页数:4
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