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Surgery in Tourette syndrome.

Yasin Temel1, Veerle Visser-Vandewalle

  • 1Department of Neurosurgery, Academic Hospital Maastricht, Maastricht, The Netherlands. yasintemel@yahoo.com

Movement Disorders : Official Journal of the Movement Disorder Society
|January 27, 2004
PubMed
Summary

Tourette syndrome (TS) is a neurological disorder causing tics. While most cases improve, some require neurosurgery, with deep brain stimulation showing promise for intractable symptoms.

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Area of Science:

  • Neuroscience
  • Neurology
  • Psychiatry

Background:

  • Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder characterized by tics.
  • TS can co-occur with behavioral issues like obsessive-compulsive disorder (OCD).
  • While often manageable, some TS cases are intractable to standard treatments.

Purpose of the Study:

  • To review historical and emerging neurosurgical treatments for intractable Tourette syndrome.
  • To evaluate the efficacy and side effects of ablative procedures and deep brain stimulation (DBS) for TS.

Main Methods:

  • Literature review of ablative neurosurgical procedures for TS from 1960-2003.
  • Analysis of case reports and textbook descriptions totaling approximately 65 patients.
  • Inclusion of recent data on deep brain stimulation (DBS) for intractable TS.

Main Results:

  • Ablative procedures for intractable TS, dating back to 1962, yielded unsatisfactory results and significant side effects in many patients.
  • Deep brain stimulation (DBS) emerged in 1999 as a novel approach.
  • Early reports on 3 patients with bilateral thalamic stimulation for TS showed promising outcomes for tics and OCD symptoms.

Conclusions:

  • Traditional ablative neurosurgery for intractable TS has a history of limited success and adverse effects.
  • Deep brain stimulation (DBS) represents a potentially effective and safer alternative for managing severe, treatment-resistant Tourette syndrome and associated OCD symptoms.

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