[Deep brain stimulation in the surgical management of Tourette syndrome]

Tourette syndrome (TS) is a neuropsychiatric disorder characterized by the presence of vocal and motor tics. Besides tics, patients with TS exhibit a variety of behavioural symptoms, particularly deficit-hyperactivity disorder and obsessive-compulsive disorder. Behavioural therapy is applied in patients with mild forms of TS but it has not been proven to be effective in the long-term follow-up. Patients with disabling motor and vocal tics are treated with neuroleptics and other agents interacting with the dopaminergic system. In most patients reaching adulthood, symptoms spontaneously decrease. Only a limited number of adult patients require long-term medication. Only those patients who were most severely disabled by tics and concomitant obsessive-compulsive disorder were treated in the past by neuroablative neurosurgical procedures. Nowadays, deep brain stimulation is applied in patients with severe forms of TS because of its safety, adjustability, and efficacy.